Provider Demographics
NPI:1558148726
Name:GAYMAN, VICKY L (RN)
Entity Type:Individual
Prefix:
First Name:VICKY
Middle Name:L
Last Name:GAYMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 N MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH PLATTE
Mailing Address - State:NE
Mailing Address - Zip Code:69101-2210
Mailing Address - Country:US
Mailing Address - Phone:308-539-0204
Mailing Address - Fax:
Practice Address - Street 1:1400 N MADISON AVE
Practice Address - Street 2:
Practice Address - City:NORTH PLATTE
Practice Address - State:NE
Practice Address - Zip Code:69101-2210
Practice Address - Country:US
Practice Address - Phone:308-535-7126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-12
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE47359163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool