Individual
BEVERLY BURT VICKNAIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2550 FLORIDA BLVD SW, DENHAM SPRINGS, LA 70726-4951
(225) 667-2792
Mailing address
12045 HOMEPORT DR, MAUREPAS, LA 70449-3043
(225) 698-3445
Taxonomy
Speciality
Code
Description
License number
State
163WH1000X
Hospice Registered Nurse
Primary
RN070442
LA
Other
Enumeration date
09/30/2008
Last updated
09/30/2008
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