MEDICARE: VICKI HOLLINGER-SIEFERMAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	28140077A	IN

General Provider Information

NPI Number	:	1356069595
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICKI HOLLINGER-SIEFERMAN

Provider Business Mailing Address
First Line	:	1212 W MARKET ST
Second Line	:
City	:	CRAWFORDSVILLE
State	:	IN
Zip	:	47933-1113
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1316 N TIBBS AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46222-3024
Country	:	US
Telephone Number	:	317-634-8330
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2022
Last Update Date	:	08/15/2022

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Directions to “ VICKI HOLLINGER-SIEFERMAN ” Practice Location

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