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General NPI Number Information
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NPI Number | 1932018157
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Entity Type | Individual
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Provider Name | SANDRA CARR VICK
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Gender | Female
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Dates
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Enumeration Date | 09/03/2026
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Last Update Date | 09/03/2026
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Provider Practice Location Address
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Address Line | 100 FAIRVIEW DR
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City | FRANKLIN
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State | VA
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Zip | 23851-1214
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Country | US
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Telephone | 757-569-6272
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Fax |
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Provider Business Mailing Address
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Address Line | 22458 CAPTAIN JOHN RD
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City | COURTLAND
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State | VA
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Zip | 23837-1211
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Country | US
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Telephone | 757-653-8149
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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 | 163WR0006X
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Taxonomy Name | Registered Nurse First Assistant
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License Number | 0001110839
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License Number State | VA
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