| Mrs Vicki Nicole Lary, CFNP | |
|
103 Basket St, Itta Bena, MS 38941-2801 | |
| (662) 254-7801 | |
| (662) 254-9173 |
| Full Name | Mrs Vicki Nicole Lary |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 20 Years |
| Location | 103 Basket St, Itta Bena, Mississippi |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083788665 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | R860262 (Mississippi) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Sunflower Home Health | Cleveland, MS | Home health agency |
| Adoration Home Health Care Mississippi | Cleveland, MS | Home health agency |
| University Of Mississippi Med Center | Jackson, MS | Hospital |
| Greenwood Leflore Hospital | Greenwood, MS | Hospital |
| University Of Mississippi Medical Center- Grenada | Grenada, MS | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| State Of Mississippi - University Of Mississippi Medical Center | 1850293036 | 846 |
| Entity Name | State Of Mississippi-university Of Mississippi Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1154317527 PECOS PAC ID: 1850293036 Enrollment ID: O20090414000575 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Vicki Nicole Lary, CFNP 2207 River Road Extended, Greenwood, MS 38930 Ph: (662) 451-9984 | Mrs Vicki Nicole Lary, CFNP 103 Basket St, Itta Bena, MS 38941-2801 Ph: (662) 254-7801 |
Yalinda Smith Roach, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 103 Basket St, Itta Bena, MS 38941 Phone: 662-254-7801 Fax: 662-254-9173 |