Healthcare Provider Details

I. General information

NPI: 1639618416
Provider Name (Legal Business Name): VICTORIA PEYTON TOMLIN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VICTORIA PEYTON HEVENER R.N

II. Dates (important events)

Enumeration Date: 02/14/2017
Last Update Date: 08/07/2023
Certification Date: 08/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 COMMERCE PARK DR
RAPHINE VA
24472-2547
US

IV. Provider business mailing address

433 SWOPE LN
FAIRFIELD VA
24435-2814
US

V. Phone/Fax

Practice location:
  • Phone: 540-490-2527
  • Fax: 540-377-2099
Mailing address:
  • Phone: 540-294-3034
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0024175016
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0001252320
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: