Lisa A Vickers, ARNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP30007200 Issued in WA

Practice address

1450 N 16TH Ave Ste 102
Yakima, WA 98902-1381

Phone

(509) 249-0105

Fax

(509) 249-0035

NPI assigned

Oct 23, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406505600000",
    "number": "1851474704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 N 16TH AVE STE 102",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989021381",
            "telephone_number": "509-249-0105",
            "fax_number": "509-249-0035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 N 16TH AVE STE 102",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989021381",
            "telephone_number": "509-249-0105",
            "fax_number": "509-249-0035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICKERS",
        "first_name": "LISA",
        "middle_name": "A",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2014-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP30007200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9647793",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Grace D Verduzco, PA-C
• Maria Angelica Verduzco, MD
• Ulysses Vergara-Borges
• Brianna Verwey
• Joseph L Vickers, MD
• Mikayla Vickers, ASSOCIATE LICSW
• Victor Immel, DMD, PS
• Vida Family Care
• Erick Fabriam Videira Paucar
• Roger E Vielbig, MD

• Psychiatric/Mental Health Nurse Practitioner in Yakima, WA
• Providers in Yakima, WA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2014; 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.