Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 5409P | KY |
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | APN17121 | TN |
NPI | 1003098963 |
---|---|
Provider Name | Ms. Rose B Vick |
First Address | Nashville, TN 37204-3609 |
Second Address | Nashville, TN 37232-3700 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/12/2007 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5409P | KY LICENSE (01) | KY |