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Individual
MRS. VICKY KILLEN ANDERSON
Active
Individual
MRS. VICKY KILLEN ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5005715
NC
363LF0000X
Family Nurse Practitioner
F0612213
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2335816
MEDICARE PTAN, GROUP WILKES
NC
01
—
NC8568A
MEDICARE PTAN, INDIVIDUAL
NC
Enumeration date
07/23/2012
Last updated
03/07/2017
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