Provider Demographics
NPI:1518310390
Name:VINSON, VIKI
Entity type:Individual
Prefix:
First Name:VIKI
Middle Name:
Last Name:VINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 FINANCIAL DRIVE
Mailing Address - Street 2:
Mailing Address - City:CABOT
Mailing Address - State:AR
Mailing Address - Zip Code:72023
Mailing Address - Country:US
Mailing Address - Phone:501-251-1031
Mailing Address - Fax:501-358-4711
Practice Address - Street 1:51 FINANCIAL DRIVE
Practice Address - Street 2:
Practice Address - City:CABOT
Practice Address - State:AR
Practice Address - Zip Code:72023
Practice Address - Country:US
Practice Address - Phone:501-251-1031
Practice Address - Fax:501-358-4711
Is Sole Proprietor?:No
Enumeration Date:2016-07-18
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR099319163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse