Individual
JOSHUA WAYNE VICKNAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3510 N CAUSEWAY BLVD, SUITE 404, METAIRIE, LA 70002-3531
(504) 779-5515
Mailing address
255 W MICHIGAN AVE, PO BOX 1123, JACKSON, MI 49201-2218
(800) 242-1131
(517) 787-4146
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN108454
LA
Other
Enumeration date
07/14/2008
Last updated
08/23/2016
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