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General NPI Number Information
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NPI Number | 1962748632
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Entity Type | Individual
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Provider Name | CHRISTINA VICKREY CYRIAC PA
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Gender | Female
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Dates
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Enumeration Date | 12/27/2012
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Last Update Date | 04/17/2018
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Provider Practice Location Address
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Address Line | 2000 6TH AVE S
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City | BIRMINGHAM
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State | AL
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Zip | 35233-2110
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Country | US
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Telephone | 205-801-5266
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Fax |
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Provider Business Mailing Address
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Address Line | 2244 ACTON PARK CIR
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City | BIRMINGHAM
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State | AL
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Zip | 35243-2555
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Country | US
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Telephone | 850-261-6382
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA9107071
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License Number State | FL
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