Provider Demographics
NPI:1639821622
Name:FLICK, VICTORIA RENEE (RN, MSN-FNP)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:RENEE
Last Name:FLICK
Suffix:
Gender:F
Credentials:RN, MSN-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6626 E 75TH ST STE 500
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2890
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5908 E STOP 11 RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46237-8683
Practice Address - Country:US
Practice Address - Phone:317-497-6800
Practice Address - Fax:317-497-6801
Is Sole Proprietor?:No
Enumeration Date:2022-01-21
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN28210820A363LF0000X
IN71012509A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily