Provider Demographics
NPI:1083218374
Name:CONN, VANESSA ANN (APRN)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:ANN
Last Name:CONN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 FM 1960 BYPASS RD E STE 122
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-3934
Mailing Address - Country:US
Mailing Address - Phone:832-781-4340
Mailing Address - Fax:
Practice Address - Street 1:1420 FM 1960 BYPASS RD E STE 122
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-3934
Practice Address - Country:US
Practice Address - Phone:832-781-4340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-26
Last Update Date:2021-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX814205163W00000X
TX1030362363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX814205OtherRN LICENSE
TX1030362OtherAPRN LICENSE