Provider Demographics
NPI:1154596526
Name:VICKI JO CARRIER INC
Entity type:Organization
Organization Name:VICKI JO CARRIER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:JO
Authorized Official - Last Name:CARRIER
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP-BC
Authorized Official - Phone:561-585-7106
Mailing Address - Street 1:105 HALF MOON CIR
Mailing Address - Street 2:#A-1
Mailing Address - City:HYPOLUXO
Mailing Address - State:FL
Mailing Address - Zip Code:33462-5487
Mailing Address - Country:US
Mailing Address - Phone:561-585-7106
Mailing Address - Fax:561-585-4982
Practice Address - Street 1:105 HALF MOON CIR
Practice Address - Street 2:#A-1
Practice Address - City:HYPOLUXO
Practice Address - State:FL
Practice Address - Zip Code:33462-5487
Practice Address - Country:US
Practice Address - Phone:561-585-7106
Practice Address - Fax:561-585-4982
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-28
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1888442363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1063616159OtherNPI-INDIVIDUAL