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Individual
BRISTYN D VICKERS
Active
Individual
BRISTYN D VICKERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
1094003
TX
363LA2100X
Acute Care Nurse Practitioner
Primary
1094003
TX
Other
Enumeration date
09/15/2022
Last updated
10/24/2022
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