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Individual

MRS. CAROL ANN VIKSE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
R.N.

Contact information

Practice address
330 DURANT AVE, P.S. 53R, STATEN ISLAND, NY 10308-3030
(718) 980-0555
Mailing address
330 DURANT AVE, P.S. 53R, STATEN ISLAND, NY 10308-3030
(718) 980-0555

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
409837-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
409837-1
RN LICENSE
NY
Enumeration date
03/08/2012
Last updated
03/08/2012
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