Provider Demographics
NPI:1306385174
Name:CURLEY, VICTORIA YVONNE
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:YVONNE
Last Name:CURLEY
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 1:517 E INDIANA AVE
Mailing Address - Street 2:
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-2848
Mailing Address - Country:US
Mailing Address - Phone:419-819-5089
Mailing Address - Fax:
Practice Address - Street 1:517 E INDIANA AVE
Practice Address - Street 2:
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537-2848
Practice Address - Country:US
Practice Address - Phone:419-819-5089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-14
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0201026374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0201026Medicaid
OH0201026Medicare PIN