Healthcare Provider Details

I. General information

NPI: 1619698586
Provider Name (Legal Business Name): VICTORIA KUTCH DNP, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2022
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 SPRINGFIELD COMMONS DR
RALEIGH NC
27609-8529
US

IV. Provider business mailing address

PO BOX 803854
KANSAS CITY MO
64180-3854
US

V. Phone/Fax

Practice location:
  • Phone: 919-235-1400
  • Fax:
Mailing address:
  • Phone: 919-350-0351
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5016834
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP028546
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: