Provider Demographics
NPI:1073104006
Name:BYERS, VICKIE LYNN
Entity Type:Individual
Prefix:
First Name:VICKIE
Middle Name:LYNN
Last Name:BYERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 TERRY AVE
Mailing Address - Street 2:
Mailing Address - City:OAK HILL
Mailing Address - State:WV
Mailing Address - Zip Code:25901-3229
Mailing Address - Country:US
Mailing Address - Phone:304-640-3609
Mailing Address - Fax:
Practice Address - Street 1:515 TERRY AVE
Practice Address - Street 2:
Practice Address - City:OAK HILL
Practice Address - State:WV
Practice Address - Zip Code:25901-3229
Practice Address - Country:US
Practice Address - Phone:304-640-3609
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-02
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant