Individual
DONNA VICKERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
100 MIMOSA DR, THOMASVILLE, GA 31792-6676
(229) 228-2834
(229) 551-8799
Mailing address
100 MIMOSA DRIVE, THOMASVILLE, GA 31792
(229) 228-2834
(229) 551-8799
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN122291
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN122291
STATE LICENSE
GA
Enumeration date
07/21/2010
Last updated
06/25/2015
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