=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578527586
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARY A. ATKINS PA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/14/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1931 MEDICAL AVE
-----------------------------------------------------
City | HARRISONBURG
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22801-3437
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 540-564-7007
-----------------------------------------------------
Fax | 540-564-7038
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1430
-----------------------------------------------------
City | HARRISONBURG
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22803-1430
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 540-564-5791
-----------------------------------------------------
Fax | 540-564-7038
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LA2100X
-----------------------------------------------------
Taxonomy Name | Acute Care Nurse Practitioner
-----------------------------------------------------
License Number | 0017001251
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------