Provider Demographics
NPI:1730384959
Name:KAUFMANN, VIRGINIA PEEBLES (CRNP)
Entity type:Individual
Prefix:MRS
First Name:VIRGINIA
Middle Name:PEEBLES
Last Name:KAUFMANN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:620 FOUNTAIN ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19128
Mailing Address - Country:US
Mailing Address - Phone:215-205-3556
Mailing Address - Fax:215-427-4441
Practice Address - Street 1:3635 N FRONT ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19140-4642
Practice Address - Country:US
Practice Address - Phone:215-427-4441
Practice Address - Fax:215-427-5562
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-18
Last Update Date:2014-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAVP003964D363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics