| NPI | 1134733611 |
|---|---|
| Former Name | HEATHER SUZANNE VICKERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: AR 212799) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: AR 212799) |
| Enumeration Date | 2020-09-02 |
| Last Update Date | 2021-02-08 |