Individual
VICKY JOHNS VANDERVORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
9900 NICHOLAS ST, STE 275, OMAHA, NE 68114-2149
(402) 493-6500
(402) 493-4370
Mailing address
9900 NICHOLAS ST, STE 250, OMAHA, NE 68114-2261
(402) 493-6500
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
927
NE
152WV0400X
Vision Therapy Optometrist
927
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025382400
—
NE
05
—
2988394
—
IA
01
—
37111
NEBRASKA BC/BS
NE
01
—
90A30
BCBS
IA
Enumeration date
07/03/2006
Last updated
06/06/2018
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