Doctor Name: | MISS VICKI LYNN MABRY |
NPI Number: | 1912995911 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APN |
License Number: | S01076 CNS |
Business Practice Address: | 4300 W 7th St Little Rock, AR - 722055446 |
Business Phone Number: | 5012575760 |
Business Fax Number: | 5012575796 |
Mailing Address: | 15 Springridge Dr, LITTLE ROCK |
State: | AR |
Postal Code: | 722115473 |
Phone Number: | 5012246658 |
Fax Number: | |
NPI Enumeration Date: | 10/12/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 364S00000X |
License Number: | S01076 CNS |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Clinical Nurse Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered nurse who, through a graduate degree program in nursing, or through a formal post-basic education program or continuing education courses and clinical experience, is expert in a specialty area of nursing practice within one or more of the components of direct patient/client care, consultation, education, research and administration. |