Provider Demographics
NPI:1578962346
Name:HALLADAY, VICKIE (RN)
Entity Type:Individual
Prefix:
First Name:VICKIE
Middle Name:
Last Name:HALLADAY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:VICKIE
Other - Middle Name:
Other - Last Name:HALLADAY-CHABRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7100 TRAVIS CIR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-2572
Mailing Address - Country:US
Mailing Address - Phone:907-444-0447
Mailing Address - Fax:
Practice Address - Street 1:711 H ST
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99501-3446
Practice Address - Country:US
Practice Address - Phone:907-770-0862
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-18
Last Update Date:2014-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK28922163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse