Provider Demographics
NPI:1558440073
Name:TUTEN, VICKIE LEE
Entity Type:Individual
Prefix:
First Name:VICKIE
Middle Name:LEE
Last Name:TUTEN
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 1:2028 MERRIMAC DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-2619
Mailing Address - Country:US
Mailing Address - Phone:910-717-7810
Mailing Address - Fax:
Practice Address - Street 1:A WOMACK ARMY MEDICAL CENTER WAMC
Practice Address - Street 2:2817 REILLY RD, MCXC-DPM
Practice Address - City:FORT BRAGG
Practice Address - State:NC
Practice Address - Zip Code:28310-7301
Practice Address - Country:US
Practice Address - Phone:910-396-2558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51280231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist