Individual
MRS. LAUREN E. VICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-6805
(207) 662-3419
Mailing address
190 RIVERSIDE ST UNIT 6B, PORTLAND, ME 04103-1073
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CNP161078
ME
Other
Enumeration date
07/21/2016
Last updated
09/18/2018
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