Provider Demographics
NPI:1740054790
Name:PERACKI, VICTORIA LYNN (FNP)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:LYNN
Last Name:PERACKI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2775 VILLAGE PT
Mailing Address - Street 2:
Mailing Address - City:CHESTERTON
Mailing Address - State:IN
Mailing Address - Zip Code:46304-0099
Mailing Address - Country:US
Mailing Address - Phone:219-628-1853
Mailing Address - Fax:800-500-1122
Practice Address - Street 1:2775 VILLAGE PT
Practice Address - Street 2:
Practice Address - City:CHESTERTON
Practice Address - State:IN
Practice Address - Zip Code:46304-0099
Practice Address - Country:US
Practice Address - Phone:734-464-0887
Practice Address - Fax:800-500-1122
Is Sole Proprietor?:No
Enumeration Date:2023-11-09
Last Update Date:2025-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71014598A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily