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General NPI Number Information
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NPI Number | 1740054790
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Entity Type | Individual
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Provider Name | VICTORIA LYNN PERACKI FNP
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Gender | Female
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Dates
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Enumeration Date | 11/09/2023
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Last Update Date | 10/31/2025
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Provider Practice Location Address
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Address Line | 2775 VILLAGE PT
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City | CHESTERTON
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State | IN
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Zip | 46304-0099
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Country | US
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Telephone | 734-464-0887
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Fax | 800-500-1122
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Provider Business Mailing Address
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Address Line | 2775 VILLAGE PT
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City | CHESTERTON
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State | IN
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Zip | 46304-0099
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Country | US
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Telephone | 219-628-1853
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Fax | 800-500-1122
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 71014598A
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License Number State | IN
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