Provider Demographics
NPI:1053609180
Name:LOUWAGIE, VICTORIA SAINSBURY (PA-C)
Entity type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:SAINSBURY
Last Name:LOUWAGIE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:VICTORIA
Other - Middle Name:LEIGH
Other - Last Name:SAINSBURY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:22766 STAVENAU LANE
Mailing Address - Street 2:
Mailing Address - City:ELYSIAN
Mailing Address - State:MN
Mailing Address - Zip Code:56028
Mailing Address - Country:US
Mailing Address - Phone:412-508-1027
Mailing Address - Fax:
Practice Address - Street 1:1025 MARSH STREET
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-4752
Practice Address - Country:US
Practice Address - Phone:412-508-1027
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-11
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical