Victoria Ann Vaccaro, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704150960 Issued in MI

Practice address

730 Kimole LN
Adrian, MI 49221-1463

Phone

(517) 263-6794

Fax

(517) 263-4275

NPI assigned

Sep 20, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Victoria Ann Theisen Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Nurse Practitioner

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380758400000",
    "number": "1609974112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 KIMOLE LN",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492211463",
            "telephone_number": "517-263-6794",
            "fax_number": "517-263-4275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 KIMOLE LN",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492211463",
            "telephone_number": "517-263-6794",
            "fax_number": "517-263-4275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VACCARO",
        "first_name": "VICTORIA",
        "middle_name": "ANN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2013-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704150960",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704150960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5181698",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VICTORIA",
            "last_name": "THEISEN",
            "middle_name": "ANN",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rosalie Turek, M.D.
• Patsyanna Turner
• U1St Transitional Living Program
• Gabrielle Kay Udell
• John William Upton, MPT
• Josh Adam Valdez
• Lauren Elizabeth Valdez, LLMSW
• Sandy Valdez
• Christopher Donald Valkier, DPM
• Sophia Maria Ann Valkier, DPM

• Family Nurse Practitioner in Adrian, MI
• Providers in Adrian, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.