Individual
MS. VICKIE RENEE PENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS,PA
Contact information
Practice address
1101 HOSPITAL DR, COLUMBIA, MO 65212-0001
(573) 882-1662
(573) 884-7318
Mailing address
PO BOX 7687, COLUMBIA, MO 65205-7687
(573) 882-2259
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2010037370
MO
363A00000X
Physician Assistant
PA965
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100509027
—
NV
Enumeration date
05/11/2006
Last updated
04/28/2025
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