Provider Demographics
NPI:1487338448
Name:LAMOREAUX, VICKIE SHERYL (LPN)
Entity type:Individual
Prefix:
First Name:VICKIE
Middle Name:SHERYL
Last Name:LAMOREAUX
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:VICKIE
Other - Middle Name:SHERYL
Other - Last Name:QUEEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NONE
Mailing Address - Street 1:11292 AUTUMN BREEZE TRL
Mailing Address - Street 2:
Mailing Address - City:CLIO
Mailing Address - State:MI
Mailing Address - Zip Code:48420-1500
Mailing Address - Country:US
Mailing Address - Phone:989-390-3523
Mailing Address - Fax:
Practice Address - Street 1:11292 AUTUMN BREEZE TRL
Practice Address - Street 2:
Practice Address - City:CLIO
Practice Address - State:MI
Practice Address - Zip Code:48420-1500
Practice Address - Country:US
Practice Address - Phone:989-390-3523
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4703081836164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse