Individual
VICKI LYNN ENDRES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
6101 LAKE ELLENOR DR, ORLANDO, FL 32809-4616
(407) 858-1400
(407) 858-5519
Mailing address
120 E BLUE WATER EDGE DR, EUSTIS, FL 32736-2252
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
116
WV
367A00000X
Advanced Practice Midwife
23563
WV
367A00000X
Advanced Practice Midwife
Primary
9360329
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001721059
MS BCBS
WV
01
—
7498050
AETNA
WV
05
—
9450012000
—
WV
Enumeration date
01/11/2006
Last updated
02/26/2018
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