| NPI | 1669626800 |
|---|---|
| Former Name | VIKKI BURLESON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 13646) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN APN0000013646) |
| Enumeration Date | 2008-11-14 |
| Last Update Date | 2018-03-22 |