Individual
TERESA S VICKERS
Active
Individual
TERESA S VICKERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
RN149574
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AG05170061
GEORGIA CERTIFICATION (NP)
GA
01
—
RN149574
RN LICENSURE
GA
Enumeration date
05/22/2017
Last updated
05/22/2017
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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