Provider Demographics
NPI:1023567880
Name:VICKERS, HEIDI (RN, MSN)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:
Last Name:VICKERS
Suffix:
Gender:F
Credentials:RN, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 ZOLLINGER RD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43221-2849
Mailing Address - Country:US
Mailing Address - Phone:614-685-8800
Mailing Address - Fax:614-293-0495
Practice Address - Street 1:1800 ZOLLINGER RD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-2849
Practice Address - Country:US
Practice Address - Phone:614-685-8800
Practice Address - Fax:614-293-0495
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-22
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN242940163WP2201X
OHCNP020201363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care