Individual
THERESA VICKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
920 CHURCH ST N, CONCORD, NC 28025-2927
(704) 512-5363
Mailing address
PO BOX 19305, CHARLOTTE, NC 28219-9305
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5005246
NC
Other
Enumeration date
03/23/2006
Last updated
09/20/2021
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