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Individual

VICKIE K WEATHERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CNS

Contact information

Practice address
307 5TH AVE SE, SUITE 502, MINOT, ND 58701-4784
(701) 857-2199
(701) 857-2199
Mailing address
1705 4TH AVE NW, MINOT, ND 58703-2912
(701) 839-0474
(701) 839-0713

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R28599
ND
164X00000X
Licensed Vocational Nurse
L9274
ND
364S00000X
Clinical Nurse Specialist
Primary
0388003-02
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
025500
BCBS OF ND PIN
ND
05
70009
ND
01
P00160106
RR MEDICARE
ND
01
P00659747
RR MEDICARE
ND
Enumeration date
06/19/2006
Last updated
03/22/2021
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