Individual
JENNIFER L VICKERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1201 7TH ST SE, DECATUR, AL 35601-3337
(256) 341-2000
(256) 306-1691
Mailing address
PO BOX 2239, DECATUR, AL 35609-2239
(205) 979-5882
(205) 979-1248
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1-102952
AL
367500000X
Certified Registered Nurse Anesthetist
ARNP9306515
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002708400
—
FL
Enumeration date
07/15/2010
Last updated
01/25/2013
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