Provider Demographics
NPI:1063432086
Name:ANDREWS, VICKI L (CFNP)
Entity type:Individual
Prefix:MS
First Name:VICKI
Middle Name:L
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:VICKI
Other - Middle Name:L
Other - Last Name:VEILLET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CFNP
Mailing Address - Street 1:1200 KENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55811-4199
Mailing Address - Country:US
Mailing Address - Phone:218-723-6282
Mailing Address - Fax:218-723-5953
Practice Address - Street 1:1200 KENWOOD AVE
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55811-4199
Practice Address - Country:US
Practice Address - Phone:218-723-6282
Practice Address - Fax:218-723-5953
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1285363LF0000X
MN284539-22363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN015R1ANOtherBCBS - MN
MN0113194OtherMEDICA
MNNA9591046223OtherPREFERRED ONE
WI43938900Medicaid