Vickers, Chad Randal
Vickers, Chad Randal is an individual health care provider with primary practice located at 135 Colorado Street East , Saint Paul MN 55107. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is his primary health care specialty. Vickers, Chad Randal can be contacted via phone (651) 489-7740.Contact Information
Primary practice address
135 Colorado Street East
Saint Paul MN 55107
Phone: (651) 489-7740
Fax: (651) 489-6458
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 706002 | Texas |
| Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 363LP0808X | 706002 | Texas |
| Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 363LP0808X | L8-0000171 | Delaware |
| Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 363LP0808X | 6371 | Minnesota |
Profile Details
| NPI number | 1780753681 |
|---|---|
| LBN Legal business name | Vickers, Chad Randal |
| Credentials | PMHNP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 6th, 2006 |
| Last updated | Apr 22nd, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1780753681 | NPPES |
| Oklahoma | MEDICAID | 200101760A | |
| Oklahoma | Other | P01078815 | |
| Oklahoma | MEDICAID | 1780753681 | |
| Oklahoma | MEDICAID | 182997003 | |
| Oklahoma | Other | 868N62 | |
| Oklahoma | MEDICAID | 182997001 |
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