Provider Demographics
NPI:1063097418
Name:RAFORD, VICKI TOINYETTE (RN)
Entity type:Individual
Prefix:
First Name:VICKI
Middle Name:TOINYETTE
Last Name:RAFORD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 PALM ISLAND DR
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31757-4035
Mailing Address - Country:US
Mailing Address - Phone:770-286-6770
Mailing Address - Fax:
Practice Address - Street 1:220 PALM ISLAND DR
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:GA
Practice Address - Zip Code:31757-4035
Practice Address - Country:US
Practice Address - Phone:770-286-6770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-16
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN134764163WH0200X, 163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice