Provider Demographics
NPI:1194396671
Name:VICKERS, BRITTANI (MSN, PNP-PC)
Entity Type:Individual
Prefix:MRS
First Name:BRITTANI
Middle Name:
Last Name:VICKERS
Suffix:
Gender:F
Credentials:MSN, PNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11310 BRINKER CT
Mailing Address - Street 2:
Mailing Address - City:CULPEPER
Mailing Address - State:VA
Mailing Address - Zip Code:22701-5102
Mailing Address - Country:US
Mailing Address - Phone:540-423-7808
Mailing Address - Fax:
Practice Address - Street 1:4424 COSTELLO WAY
Practice Address - Street 2:
Practice Address - City:HAYMARKET
Practice Address - State:VA
Practice Address - Zip Code:20169-2996
Practice Address - Country:US
Practice Address - Phone:703-753-1895
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-07
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA104410158163WN0003X
VA202119582208000000X
VA0024180960363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163WN0003XNursing Service ProvidersRegistered NurseNeonatal, Low-Risk
No208000000XAllopathic & Osteopathic PhysiciansPediatrics