Marta Vickers
Individual provider Active NPI Family Nurse Practitioner · Fort Detrick, MD
NPI 1760460968 · NPPES record last updated Jan 29, 2009
Key facts
- NPI
- 1760460968
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- R13197 (NM)
- Practice address
- 1434 Porter St
Fort Detrick, MD 21702-9210 - Phone
- (301) 619-4820
- NPI assigned
- Jan 6, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R13197 | NM | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frederick Health Hospital Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R13197 | NM | Yes |
Addresses
Primary practice location
1434 Porter St
Fort Detrick, MD 21702-9210
Mailing address
1434 Porter St
Fort Detrick, MD 21702-9254
Phone (301) 619-4820
Other providers in Fort Detrick, MD
- Tina Woodring Silver
- Karen Alicia Simpson
- Bryony W. Soltis
- Sandra Lee Summers
- Robert Hugo Vandre Jr.
- Charlene Laverne Warrendavis
- Amy Lynn Westermann
- Diahann Johnson White
- Elaine Marie Williams
- Erica Winpigler
All providers in Fort Detrick, MD · Family Nurse Practitioner in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 29, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.