Provider Demographics
NPI:1619018595
Name:VICKERY, VIRGINIA MCROY (MS)
Entity Type:Individual
Prefix:MRS
First Name:VIRGINIA
Middle Name:MCROY
Last Name:VICKERY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 335
Mailing Address - Street 2:
Mailing Address - City:SIMPSON
Mailing Address - State:NC
Mailing Address - Zip Code:27879-0335
Mailing Address - Country:US
Mailing Address - Phone:252-328-9334
Mailing Address - Fax:252-328-0839
Practice Address - Street 1:2780 DICKINSON AVE
Practice Address - Street 2:SUITE B
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834
Practice Address - Country:US
Practice Address - Phone:252-328-9334
Practice Address - Fax:252-328-0839
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS