Provider Demographics
NPI:1588115356
Name:CABRAL, VICTORIA MARIE (DNP, AGPCNP-BC)
Entity type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:MARIE
Last Name:CABRAL
Suffix:
Gender:F
Credentials:DNP, AGPCNP-BC
Other - Prefix:MISS
Other - First Name:VICTORIA
Other - Middle Name:MARIE
Other - Last Name:VIEIRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 MILL RD
Mailing Address - Street 2:SUITE 180
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-5252
Mailing Address - Country:US
Mailing Address - Phone:508-973-2000
Mailing Address - Fax:508-973-2001
Practice Address - Street 1:100 ROSEBROOK WAY
Practice Address - Street 2:
Practice Address - City:WAREHAM
Practice Address - State:MA
Practice Address - Zip Code:02571-1138
Practice Address - Country:US
Practice Address - Phone:508-273-4900
Practice Address - Fax:508-273-4901
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-17
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2261721363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110120097AMedicaid
MAS400355899Medicare PIN