Individual
VICKI HISAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
24077 STATE HIGHWAY 49, NEVADA CITY, CA 95959-8519
(530) 265-9057
Mailing address
24077 STATE HIGHWAY 49, NEVADA CITY, CA 95959-8519
(530) 265-9057
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN 364418
CA
Other
Enumeration date
07/08/2014
Last updated
07/08/2014
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