| Doctor Name: | MRS. CARA CHADBOURNE VICKERS |
| NPI Number: | 1023241254 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | PA 3816 |
| Business Practice Address: | 489 Bernardston Rd Suite 108 Greenfield, MA - 013011238 |
| Business Phone Number: | 4133258500 |
| Business Fax Number: | 4137726866 |
| Mailing Address: | 489 Bernardston Rd, Suite 108 GREENFIELD |
| State: | MA |
| Postal Code: | 013011238 |
| Phone Number: | 4133258500 |
| Fax Number: | 4137726866 |
| NPI Enumeration Date: | 09/04/2009 |
| NPI Last Update Date: | 04/17/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA 3816 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |