Vaclavik, Ida Trice
Vaclavik, Ida Trice is an individual health care provider with primary practice located at 601 Watkins Centre Pkwy Suite 200, Midlothian VA 23114-0002. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Vaclavik, Ida Trice can be contacted via phone (804) 594-3130.Contact Information
Primary practice address
601 Watkins Centre Pkwy Suite 200
Midlothian VA 23114-0002
Phone: (804) 594-3130
Fax: (804) 423-6517
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | RN1008705 | District of Columbia |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 0024172575 | Virginia |
Profile Details
| NPI number | 1134408644 |
|---|---|
| LBN Legal business name | Vaclavik, Ida Trice |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 15th, 2011 |
| Last updated | May 21st, 2015 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1134408644 | NPPES |
| Virginia | Other | C09633 | GROUP PTAN |
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