Provider Demographics
NPI:1861209710
Name:MOSTELLER, VICKI E (RN)
Entity type:Individual
Prefix:
First Name:VICKI
Middle Name:E
Last Name:MOSTELLER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:VICKI
Other - Middle Name:ROBERTS
Other - Last Name:SHAW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6 ROBERTS RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-8699
Mailing Address - Country:US
Mailing Address - Phone:855-694-8288
Mailing Address - Fax:
Practice Address - Street 1:39 OLD FIDDLE RD
Practice Address - Street 2:
Practice Address - City:WAYNESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28786-7882
Practice Address - Country:US
Practice Address - Phone:478-319-0258
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-13
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC91947163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice