Individual
MRS. VICKIE LEE NISSLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
140 STEPNEY LN, EDGEWATER, MD 21037-2801
(141) 022-2103
Mailing address
8070 MAYWOOD AVE, PASADENA, MD 21122-3713
(144) 363-1506
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
R171939
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4598
—
MD
Enumeration date
04/23/2007
Last updated
07/08/2007
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