Individual
MRS. EDITH ANN VICKERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNFA
Contact information
Practice address
3302 BILL OWENS PKWY, LONGVIEW, TX 75605-1612
(903) 297-2958
Mailing address
3302 BILL OWENS PKWY, LONGVIEW, TX 75605-1612
(903) 297-2958
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
548718
TX
Other
Enumeration date
09/13/2007
Last updated
09/13/2007
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