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Dr. Nathan Vicknair, STUDENT
Student in an Organized Health Care Education/Training Program in Pueblo, Colorado
NPI 1376171298

Nathan Vicknair is a Student in an Organized Health Care Education/Training Program based in Kennewick, CO. Nathan Vicknair practices in Pueblo, CO and has the professional credentials of STUDENT. The NPI Number for Nathan Vicknair is 1376171298 and holds a License No. (Colorado).

The current practice location address for Nathan Vicknair is 400 W 16Th St, Pueblo, CO and can be reached out via phone at 719-584-4000.

Location: 400 W 16Th St, Pueblo, CO, 99336-6304
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1376171298
Provider Name
Nathan Vicknair
Credential
STUDENT
Provider Entity Type
Individual
Gender
Male
Address
400 W 16Th St, Pueblo, CO, 99336-6304
Phone Number
719-584-4000
Fax Number
Provider Enumeration Date
03/27/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
400 W 16Th St
City
Pueblo
State
Colorado
Zip
81003-2745
Phone Number
719-584-4000
Fax Number
person
Provider Business Mailing Address Details
Address
400 W 16Th St
City
Pueblo
State
Colorado
Zip
81003-2745
Phone Number
719-584-4000
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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