Provider Demographics
NPI:1710221379
Name:SWEET, VICKI C (RN)
Entity Type:Individual
Prefix:
First Name:VICKI
Middle Name:C
Last Name:SWEET
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34334 CALLE NARANJA
Mailing Address - Street 2:
Mailing Address - City:CAPISTRANO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92624-1058
Mailing Address - Country:US
Mailing Address - Phone:949-422-6026
Mailing Address - Fax:
Practice Address - Street 1:34334 CALLE NARANJA
Practice Address - Street 2:
Practice Address - City:CAPISTRANO BEACH
Practice Address - State:CA
Practice Address - Zip Code:92624-1058
Practice Address - Country:US
Practice Address - Phone:949-422-6026
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-20
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA397142163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency