Provider Demographics
NPI:1568027613
Name:VICKERS, SARAH E (NP-C)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:E
Last Name:VICKERS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2660 S WOODLOCH ST
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77385-8556
Mailing Address - Country:US
Mailing Address - Phone:281-733-9925
Mailing Address - Fax:
Practice Address - Street 1:2660 S WOODLOCH ST
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77385-8556
Practice Address - Country:US
Practice Address - Phone:281-733-9925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-03
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX140442363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily