Healthcare Provider Details

I. General information

NPI: 1124133244
Provider Name (Legal Business Name): VICKI YOUNG HAIGHT N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VICKI L HAIGHT

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 09/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 UNIVERSITY DR
HERSHEY PA
17033-2360
US

IV. Provider business mailing address

500 UNIVERSITY DR
HERSHEY PA
17033-2360
US

V. Phone/Fax

Practice location:
  • Phone: 717-531-6585
  • Fax: 717-531-0429
Mailing address:
  • Phone: 800-243-1455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberUP-004347-B
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: