Kelly Vanvickle
Nurse Practitioner - Women's Health
49725 County 83
Staples
, Minnesota 56479-5280
Kelly Vanvickle
Nurse Practitioner - Women's Health
49725 County 83
Staples
, Minnesota 56479-5280
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About
Features
Specialties
- Nurse Practitioner - Women's Health
Languages spoken
- English
Location
First Address
- Kelly Vanvickle
- Po Box 65
- Crosslake, MN
- Zip : 56442-0065
- Phone :
Second Address
- Kelly Vanvickle
- 49725 County 83
- Staples, MN
- Zip : 56479-5280
- Phone : (218) 894-1515
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Is Kelly Vanvickle accepting new patients?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LW0102X | Nurse Practitioner - Women's Health | R147459-6 | MN |
National Provider Identifier
| NPI | 1013332105 |
|---|---|
| Provider Name | Kelly Vanvickle |
| First Address | Crosslake, MN 56442-0065 |
| Second Address | Staples, MN 56479-5280 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 26/02/2014 |
| Last Update Date | 15/09/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.