Provider Demographics
NPI:1902800279
Name:TROESCHEL, SANDRA AKIKO (NP)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:AKIKO
Last Name:TROESCHEL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 TRISTEN DR
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN
Mailing Address - State:VA
Mailing Address - Zip Code:23693-4137
Mailing Address - Country:US
Mailing Address - Phone:757-599-6333
Mailing Address - Fax:757-599-9425
Practice Address - Street 1:101 PHILIP ROTH ST
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-1393
Practice Address - Country:US
Practice Address - Phone:757-599-6333
Practice Address - Fax:757-599-9425
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0017001246363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
006480P39Medicare ID - Type Unspecified
S93710Medicare UPIN