Provider Demographics
NPI:1912714643
Name:ROSS, VICTORIA ERIN
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:ERIN
Last Name:ROSS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9756 OLCOTT AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT JOHN
Mailing Address - State:IN
Mailing Address - Zip Code:46373-9548
Mailing Address - Country:US
Mailing Address - Phone:219-276-0655
Mailing Address - Fax:
Practice Address - Street 1:9756 OLCOTT AVE
Practice Address - Street 2:
Practice Address - City:SAINT JOHN
Practice Address - State:IN
Practice Address - Zip Code:46373-9548
Practice Address - Country:US
Practice Address - Phone:219-276-0655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-16
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program