Healthcare Provider Details

I. General information

NPI: 1619850476
Provider Name (Legal Business Name): VICKI GETTEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2025
Last Update Date: 07/29/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3412 WHEATLAND LN
PLANO TX
75025-3614
US

IV. Provider business mailing address

3412 WHEATLAND LN
PLANO TX
75025-3614
US

V. Phone/Fax

Practice location:
  • Phone: 972-898-0888
  • Fax:
Mailing address:
  • Phone: 972-898-0888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number244267
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: