Individual
SHANNON E VICKERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
6221 PHYSICIANS CT, STE 1, EVANSVILLE, IN 47715-4031
(812) 479-3453
(812) 473-8166
Mailing address
PO BOX 1510, EVANSVILLE, IN 47706-1510
(812) 479-3453
(812) 473-8166
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71004620A
IN
363LF0000X
Family Nurse Practitioner
71004620A
IN
Other
Enumeration date
09/14/2013
Last updated
03/17/2017
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