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Individual
VICTORIA MANSFIELD
Active
Individual
VICTORIA MANSFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
3785
TN
363AM0700X
Medical Physician Assistant
PA00419
MS
363AS0400X
Surgical Physician Assistant
3785
TN
363AS0400X
Surgical Physician Assistant
Primary
PA00419
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3785
TN LICENSE
TN
01
—
PA00419
MS LICENSE
MS
Enumeration date
01/25/2019
Last updated
04/17/2024
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