Polly T Vick, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

675722 Issued in TX

Practice address

2300 E. Rancier Ave, Ste 103
Killeen, TX 76543-3450

Phone

(254) 200-2310

Fax

(254) 200-2340

NPI assigned

Dec 6, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• New Dawn Services

  • Professional Counselor
  • Killeen, TX
  • NPI 1881035004
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445212800000",
    "number": "1285793570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 E. RANCIER AVE, STE 103",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765433450",
            "telephone_number": "254-200-2310",
            "fax_number": "254-200-2340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 E. RANCIER AVE, STE 103",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765433450",
            "telephone_number": "254-200-2310",
            "fax_number": "254-200-2340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICK",
        "first_name": "POLLY",
        "middle_name": "T",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-06",
        "last_updated": "2015-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "675722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Ventura
• Monica Rose Versie, OTR
• Vertex Lane LLC
• Veteran Home Care LLC
• Harold Louis Vick Jr., NP
• Ayana Ethel Videau
• Angelica Villafuerte
• Bre Michelle Villalobos
• Joseluis Alexandre Villalobos, RBT
• Alexius Villanueva

• Family Nurse Practitioner in Killeen, TX
• Providers in Killeen, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.