Individual
MISS ASHLEY CATHERINE VICKNAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
180 JOE WIMBERLEY BLVD STE 102, WIMBERLEY, TX 78676-6083
(512) 847-7700
Mailing address
2601 BOLTON ST, AUSTIN, TX 78748-3929
(512) 797-7568
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
691127
TX
Other
Enumeration date
10/18/2010
Last updated
10/18/2010
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