Provider Demographics
NPI:1740423706
Name:BEAR, VICKIE ANN (LPN)
Entity Type:Individual
Prefix:MRS
First Name:VICKIE
Middle Name:ANN
Last Name:BEAR
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5602 4TH ST
Mailing Address - Street 2:
Mailing Address - City:SCIOTOVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45662-5408
Mailing Address - Country:US
Mailing Address - Phone:740-776-7842
Mailing Address - Fax:
Practice Address - Street 1:5602 4TH ST
Practice Address - Street 2:
Practice Address - City:SCIOTOVILLE
Practice Address - State:OH
Practice Address - Zip Code:45662-5408
Practice Address - Country:US
Practice Address - Phone:740-776-7842
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-07
Last Update Date:2009-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN121280164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse