Provider Demographics
NPI:1467829457
Name:VICKREY, SARAH JO (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:JO
Last Name:VICKREY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6701 AIRPORT BLVD STE D143
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-6701
Mailing Address - Country:US
Mailing Address - Phone:251-342-3949
Mailing Address - Fax:251-266-3361
Practice Address - Street 1:6801 AIRPORT BLVD
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-3709
Practice Address - Country:US
Practice Address - Phone:251-266-3580
Practice Address - Fax:251-266-3581
Is Sole Proprietor?:No
Enumeration Date:2015-08-26
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-113704363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner