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General NPI Number Information
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NPI Number | 1598447609
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Entity Type | Individual
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Provider Name | PATESHIA VICKERS APRN
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Gender | Female
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Dates
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Enumeration Date | 08/07/2023
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 455 FAIRWAY DR FL 2
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City | DEERFIELD BEACH
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State | FL
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Zip | 33441-1809
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Country | US
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Telephone | 561-985-4188
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Fax |
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Provider Business Mailing Address
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Address Line | 2582 SW 14TH TER
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City | PAHOKEE
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State | FL
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Zip | 33476-2804
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Country | US
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Telephone | 561-985-4188
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | RN9352228
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License Number State | FL
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