| Doctor Name: | MARTA VICKERS |
| NPI Number: | 1760460968 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | R13197 |
| Business Practice Address: | 1434 Porter St Fort Detrick, MD - 217029210 |
| Business Phone Number: | 3016194820 |
| Business Fax Number: | |
| Mailing Address: | 1434 Porter St, FORT DETRICK |
| State: | MD |
| Postal Code: | 217029254 |
| Phone Number: | 3016194820 |
| Fax Number: | |
| NPI Enumeration Date: | 01/06/2006 |
| NPI Last Update Date: | 01/29/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | R13197 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |