MRS. KELLI ANN VICKREY


Address: 2600 Cherry Ln Ste 140, Fort Worth, TX 76116-3961
Phone: 8175604540

MRS. KELLI ANN VICKREY (NPI# 1255984837) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1255984837
Entity Type Individual
Full Name MRS. KELLI ANN VICKREY
Credential FNP-C
Practice Address 2600 Cherry Ln Ste 140
Fort Worth
TX 76116-3961
Practice Telephone 8175604540
Mailing Telephone 8175604540
Enumeration Date 2019-07-22
Last Update Date 2019-07-22
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LF0000X Nurse Practitioner
Specialization: Family
AP142103 TX Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 2600 CHERRY LN STE 140
City FORT WORTH
State TX
Zip Code 76116-3961

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NPI Name Taxonomy Address Enumeration
1952908980 William Michael Marshall Pharmacist 8600 Camp Bowie Blvd, Forth Worth, TX 76116 2020-10-02
1558843599 Donnisha Bunting In Home Supportive Care 2901 Broadmoor, 1115, Fort Worth, TX 76116 2018-09-06
1588156756 Bilal Master Student in an Organized Health Care Education/Training Program 3309 Riveroad Court, 2515, Ft Worth, TX 76116 2018-06-04
1245769728 Randall R Williams Physical Therapist 6913 Camp Bowie Blvd Suite 141, Fort Worth, TX 76116 2017-06-08
1023543048 5th Avenue Grooming Lounge Prosthetic/Orthotic Supplier 1201 N Watson Rd., Suite 283, Arlington, TX 76116 2017-04-27
1831647734 Frisco Neuro Collaborations, Pllc Physician Assistant 6387 Camp Bowie Blvd Ste B-640, Fort Worth, TX 76116 2016-09-20
1104288372 Brown Mobile Dental Pa Dentist 8008 Camp Bowie W Blvd, Ste 101, Fort Worth, TX 76116 2016-03-25
1639553431 Bartholomew A Akubukwe Pharmacist 6700 Westfree Way, Fortworth, TX 76116 2015-07-13
1952718868 Brown Mobile Dental Dentist 8008 Camp Bowie Suite 101, Fort Worth, TX 76116 2014-07-14
1275949018 Emily Sue Danner Dentist 6726 Camp Bowie Blvd., Fort Worth, TX 76116 2014-07-01
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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

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NPI Name Taxonomy Address Enumeration
1417556341 Sarah R Tabor Nurse Practitioner 4819 El Campo Ave, Fort Worth, TX 76107-4917 2020-10-21
1336747963 Thomas Liles Nurse Practitioner 4 Carlson Ct, Fort Worth, TX 76119-5901 2020-10-15
1518565597 Khyatiben Harsh Parikh Nurse Practitioner 8121 Belgian Blue Ct, Fort Worth, TX 76131-1734 2020-10-13
1225645906 Manju Karki K C Nurse Practitioner 4812 Meadow Falls Dr # A, Fort Worth, TX 76244-2308 2020-09-28
1497361778 Mulikat Dossou Nurse Practitioner 8024 Valley Crest Dr, Fort Worth, TX 76120-5651 2020-09-22
1275148793 Bianca Adrianna Agnello Nurse Practitioner 8465 Boat Club Rd Ste 115, Fort Worth, TX 76179-3676 2020-09-11
1356955363 Alba C. Rivas Nurse Practitioner 6958 Legato Ln, Fort Worth, TX 76134-3727 2020-09-07
1043824139 Traci D Huff Nurse Practitioner 7121 Sundance Ln, Fort Worth, TX 76179-2533 2020-09-04
1669085437 Ryan Bourgeois Nurse Practitioner 2917 Crocket Street, Fort Worth, TX 76107 2020-08-31
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Competitor

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City FORT WORTH
Zip Code 76116

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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