Individual
MRS. HAYLEY RENE VICKERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA, DNP-A
Contact information
Practice address
6606 LBJ FWY, SUITE 200, DALLAS, TX 75240-6533
(972) 715-9976
(972) 715-9976
Mailing address
PO BOX 650865, DALLAS, TX 75265-0865
(972) 715-5000
(972) 715-9976
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
770464
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
770464
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
343065402
—
TX
01
—
8341UK
BCBS
TX
Enumeration date
01/08/2015
Last updated
11/03/2015
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