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NPI Code Detail

MEDICARE: VICTORIA BARAJAS

MEDICARE: VICTORIA BARAJAS
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
1363LF0000XFamily Nurse Practitioner28164204AIN

General Provider Information

NPI Number : 1487098935
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICTORIA BARAJAS
Provider Business Mailing Address
First Line : 7739 E 112TH AVE
Second Line :
City : CROWN POINT
State : IN
Zip : 46307-5700
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2272 N MAIN ST
Second Line :
City : CROWN POINT
State : IN
Zip : 46307-1802
Country : US
Telephone Number : 219-286-4518
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2013
Last Update Date : 04/25/2013

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Directions to “ VICTORIA BARAJAS ” Practice Location

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