Basic Information
| Provider Information | |||||||||
| NPI: | 1578527586 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ATKINS | ||||||||
| FirstName: | MARY | ||||||||
| MiddleName: | A. | ||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1430 | ||||||||
| Address2: | |||||||||
| City: | HARRISONBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 228031430 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5405645791 | ||||||||
| FaxNumber: | 5405647038 | ||||||||
| Practice Location | |||||||||
| Address1: | 1931 MEDICAL AVE | ||||||||
| Address2: | |||||||||
| City: | HARRISONBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 228013437 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5405647007 | ||||||||
| FaxNumber: | 5405647038 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/14/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2100X | 0017001251 | VA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care |
ID Information
| ID | Type | State | Issuer | Description | 7780133 | 05 | VA | MEDICAID | 7104062000 | 01 | WV | WEST VIRGINIA MEDICAID | OTHER | 257337 | 01 | ANTHEM/BCBS | OTHER | O83432 | 01 | SENTARA | OTHER |