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NPI Code Detail

MEDICARE: MS. VICKI JAN FOX RN, ACNP-CS

MEDICARE: MS. VICKI JAN FOX RN, ACNP-CS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2100XAcute Care Nurse Practitioner232779TX

General Provider Information

NPI Number : 1649277138
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. VICKI JAN FOX RN, ACNP-CS
Provider Business Mailing Address
First Line : 2001 ROSE RD
Second Line :
City : TYLER
State : TX
Zip : 75701-4739
Country : US
Telephone Number : 903-592-2569
Fax Number : 903-533-9252
Provider Business Practice Location Address
First Line : 800 E DAWSON ST
Second Line :
City : TYLER
State : TX
Zip : 75701-2036
Country : US
Telephone Number : 903-592-2569
Fax Number : 903-533-9252
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2005
Last Update Date : 07/08/2007

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