Virginia Ann Buccola, PMHNP
Nurse Practitioner, Psych/Mental Health in Tacoma, WA. Individual provider (NPI-1).
NPI number1124398482
StatusActive
Last updated in NPPESJan 29, 2019
Details
- NPI
- 1124398482
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Virginia Ann Buccola
- Credential
- PMHNP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 4, 2012
- Last updated
- Jan 29, 2019
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - NURSE PRACTITIONER
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | AP60296557 | WA | Yes |
| 163W00000X | Registered Nurse | RN00125750 | WA |
Practice location
1202 Mlk Jr WayTacoma, WA 98405
Phone 253-441-4743 · Fax 253-620-5831
Mailing address
405 6th AveApt 503
Tacoma, WA 98402
Phone 253-620-5015 · Fax 253-620-5831
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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