Individual
MRS. VICKY LYNNE FAIREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN,C
Contact information
Practice address
HIGHWAY J NORTH BOX 441, HAYTI, MO 63851
(573) 359-2600
Mailing address
943 JEFFERSON AVE, CARUTHERSVILLE, MO 63830-1757
(573) 333-2894
(573) 333-2607
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
142179
MO
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
142179
MO
Other
Enumeration date
03/28/2007
Last updated
09/11/2025
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