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General NPI Number Information
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NPI Number | 1326277344
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Entity Type | Individual
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Provider Name | VICKI CHRISTINE RAY DNP APNP
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Gender | Female
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Dates
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Enumeration Date | 07/12/2009
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Last Update Date | 01/10/2023
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Provider Practice Location Address
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Address Line | 225 MEMORIAL DR
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City | BERLIN
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State | WI
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Zip | 54923-1243
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Country | US
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Telephone | 920-830-6877
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Fax |
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Provider Business Mailing Address
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Address Line | 225 MEMORIAL DR
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City | BERLIN
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State | WI
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Zip | 54923-1243
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Country | US
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Telephone | 920-361-5535
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 3779-033
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3779
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License Number State | WI
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