Doctor Name: | VICKI MICHELLE VANDERHOFF |
NPI Number: | 1104168160 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-BC |
License Number: | R135307-3 |
Business Practice Address: | 551 4th St N Winsted, MN - 553954523 |
Business Phone Number: | 9524423190 |
Business Fax Number: | |
Mailing Address: | 551 4th St N, WINSTED |
State: | MN |
Postal Code: | 553954523 |
Phone Number: | 9524423190 |
Fax Number: | |
NPI Enumeration Date: | 03/17/2013 |
NPI Last Update Date: | 03/17/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | R135307-3 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |