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General NPI Number Information
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NPI Number | 1629127246
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Entity Type | Individual
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Provider Name | VICKI LYNN SHIVELY R.N., PHN
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Gender | Female
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 207 N BUTTE ST
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City | WILLOWS
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State | CA
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Zip | 95988-2803
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Country | US
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Telephone | 530-934-5431
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Fax |
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Provider Business Mailing Address
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Address Line | 6440 WESTGATE LN
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City | WILLOWS
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State | CA
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Zip | 95988-9787
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Country | US
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Telephone | 530-934-5431
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN371323
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 163WA2000X
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Taxonomy Name | Administrator Registered Nurse
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License Number | RN371323
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | RN371323
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number | RN371323
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License Number State | CA
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