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Individual

DR. JENNIFER G VICK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
3024 NEW BERN AVE, RALEIGH, NC 27610-1247
(919) 350-8493
Mailing address
2920 HIGHWOODS BLVD, RALEIGH, NC 27604-0010
(877) 498-4490

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2007-00838
NC
2080P0210X
Pediatric Nephrology Physician
2007-00838
NC

Other

Enumeration date
12/17/2007
Last updated
04/14/2021
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