Individual
MARLENE VICKERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
845 S MADISON ST, TUPELO, MS 38801-4905
(662) 377-2539
(662) 377-2920
Mailing address
450 E PRESIDENT AVE, TUPELO, MS 38801-5599
(662) 377-4685
(662) 377-2755
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R872088
MS
Other
Enumeration date
01/16/2015
Last updated
01/16/2015
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