Doctor Name: | MS. VICKI LOU STORK |
NPI Number: | 1336325802 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 079618 |
Business Practice Address: | 311 S Clark St Carroll, IA - 514013038 |
Business Phone Number: | 7127940826 |
Business Fax Number: | |
Mailing Address: | 131 W 3rd St., GLIDDEN |
State: | IA |
Postal Code: | 51443 |
Phone Number: | 7128302511 |
Fax Number: | |
NPI Enumeration Date: | 01/15/2008 |
NPI Last Update Date: | 01/15/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WM0705X |
License Number: | 079618 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IA |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Medical-Surgical |
Taxonomy Definition: |