Individual
KAYLEE SUE VICKERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4513 N 2ND DR, PHOENIX, AZ 85013-2912
(615) 419-4797
Mailing address
4513 N 2ND DR, PHOENIX, AZ 85013-2912
(615) 419-4797
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7675
AZ
363A00000X
Physician Assistant
PA14842
TX
Other
Enumeration date
11/19/2019
Last updated
05/17/2025
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