Healthcare Provider Details

I. General information

NPI: 1558949479
Provider Name (Legal Business Name): VIRGINIA TRITSCHLER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2021
Last Update Date: 03/31/2021
Certification Date: 03/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 CENTRAL AVE
LYNN MA
01901-1201
US

IV. Provider business mailing address

20 CENTRAL AVE
LYNN MA
01901-1201
US

V. Phone/Fax

Practice location:
  • Phone: 781-596-2502
  • Fax: 781-596-3966
Mailing address:
  • Phone: 781-596-2502
  • Fax: 781-596-3966

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number121327
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: