Provider Demographics
NPI:1003465949
Name:SELLS, VICKIE LEE
Entity Type:Individual
Prefix:MRS
First Name:VICKIE
Middle Name:LEE
Last Name:SELLS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:VICKIE
Other - Middle Name:LEE
Other - Last Name:PRICE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:113 WARRIOR FALLS DR
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37664-5299
Mailing Address - Country:US
Mailing Address - Phone:423-276-1381
Mailing Address - Fax:
Practice Address - Street 1:113 WARRIOR FALLS DR
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37664-5299
Practice Address - Country:US
Practice Address - Phone:423-276-1381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-04
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider