Individual
VICKIE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
1846 E INNOVATION PARK DR, ORO VALLEY, AZ 85755-1963
(520) 771-0555
(262) 260-9109
Mailing address
PO BOX 2178, WILSONVILLE, OR 97070-2178
(503) 678-5626
(503) 678-2223
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
250787
AZ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
AP142086
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AP142086
NURSE PRACTITIONER
TX
Enumeration date
09/25/2019
Last updated
08/09/2021
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