Provider Demographics
NPI:1629952296
Name:WARRAD, VICKI LEA
Entity type:Individual
Prefix:
First Name:VICKI
Middle Name:LEA
Last Name:WARRAD
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2219 HANFORD ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51109-1133
Mailing Address - Country:US
Mailing Address - Phone:712-212-1906
Mailing Address - Fax:
Practice Address - Street 1:87875 554 AVE
Practice Address - Street 2:
Practice Address - City:HARTINGTON
Practice Address - State:NE
Practice Address - Zip Code:68739-5059
Practice Address - Country:US
Practice Address - Phone:712-212-1906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1-36A-10.5171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter