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General NPI Number Information
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NPI Number | 1649215070
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Entity Type | Individual
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Provider Name | VICKIE K WEATHERS CNS
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Gender | Female
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Dates
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Enumeration Date | 06/19/2006
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Last Update Date | 03/22/2021
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Provider Practice Location Address
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Address Line | 307 5TH AVE SE SUITE 502
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City | MINOT
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State | ND
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Zip | 58701-4784
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Country | US
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Telephone | 701-857-2199
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Fax | 701-857-2199
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Provider Business Mailing Address
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Address Line | 1705 4TH AVE NW
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City | MINOT
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State | ND
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Zip | 58703-2912
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Country | US
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Telephone | 701-839-0474
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Fax | 701-839-0713
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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 | R28599
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License Number State | ND
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Taxonomy #2
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Taxonomy Code | 164X00000X
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Taxonomy Name | Licensed Vocational Nurse
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License Number | L9274
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License Number State | ND
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Taxonomy #3
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Taxonomy Code | 364S00000X
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Taxonomy Name | Clinical Nurse Specialist
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License Number | 0388003-02
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License Number State | ND
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