Provider Demographics
NPI:1326120098
Name:SHOWALTER, VICKIE A (RN, CRNFA)
Entity Type:Individual
Prefix:MS
First Name:VICKIE
Middle Name:A
Last Name:SHOWALTER
Suffix:
Gender:F
Credentials:RN, CRNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4380 2ND AVE NE
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34120-9027
Mailing Address - Country:US
Mailing Address - Phone:305-824-1107
Mailing Address - Fax:305-558-0570
Practice Address - Street 1:15175 EAGLE NEST LN
Practice Address - Street 2:SUITE 108
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2244
Practice Address - Country:US
Practice Address - Phone:305-824-1107
Practice Address - Fax:305-558-0570
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN-1768932163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical