Provider Demographics
NPI:1093910119
Name:PRICE, VANESSA A (APRN)
Entity Type:Individual
Prefix:MS
First Name:VANESSA
Middle Name:A
Last Name:PRICE
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:PO BOX 148
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:KY
Mailing Address - Zip Code:42347-0148
Mailing Address - Country:US
Mailing Address - Phone:270-504-1940
Mailing Address - Fax:
Practice Address - Street 1:20 E MCMURTRY AVE
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:KY
Practice Address - Zip Code:42347-1647
Practice Address - Country:US
Practice Address - Phone:270-504-1300
Practice Address - Fax:270-504-1380
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2016-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3005237363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100035500Medicaid
KY000000618767OtherANTHEM # WITH CHS, INC.
KY7100035500Medicaid