Individual
VICKI R DEWEESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
475 REED RD STE 104, DALTON, GA 30720-6307
(706) 529-8710
(706) 529-8715
Mailing address
475 REED RD STE 104, DALTON, GA 30720-6307
(706) 529-8710
(706) 529-8715
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
6358
TN
363L00000X
Nurse Practitioner
Primary
RN145900
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000848658
—
GA
Enumeration date
10/18/2005
Last updated
01/24/2024
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