| NPI | 1437526894 |
|---|---|
| Former Name | KELLI S VICEK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AK 133545) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: LA 227339) |
| 363LF0000X Nurse Practitioner, Family (Licence: OR 201506440NP-PP) | |
| Enumeration Date | 2015-09-01 |
| Last Update Date | 2025-04-23 |