Individual
CHRISTY K VICKERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
751 FOREST AVE, SUITE 401, ZANESVILLE, OH 43701-2868
(740) 454-8502
Mailing address
860 BETHESDA DR, ZANESVILLE, OH 43701
(740) 454-4651
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
NP04987
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0989499
GROUP MEDICAID
OH
Enumeration date
10/03/2007
Last updated
04/01/2008
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