MEDICARE: VICTORIA HARGROVE NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	903526	MS
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	1180976	AL

General Provider Information

NPI Number	:	1164073227
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTORIA HARGROVE NP

Provider Business Mailing Address
First Line	:	2473 HIGHWAY 69 S
Second Line	:
City	:	COLUMBUS
State	:	MS
Zip	:	39702-9248
Country	:	US
Telephone Number	:	662-251-3611
Fax Number	:

Provider Business Practice Location Address
First Line	:	2473 HIGHWAY 69 S
Second Line	:
City	:	COLUMBUS
State	:	MS
Zip	:	39702-9248
Country	:	US
Telephone Number	:	662-251-3611
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2019
Last Update Date	:	07/08/2025

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Directions to “ VICTORIA HARGROVE NP” Practice Location

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