Provider Demographics
NPI:1275644940
Name:CHEEVES, VANITA LOIS (FNP)
Entity Type:Individual
Prefix:MISS
First Name:VANITA
Middle Name:LOIS
Last Name:CHEEVES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 OCONNOR ST
Mailing Address - Street 2:
Mailing Address - City:YOAKUM
Mailing Address - State:TX
Mailing Address - Zip Code:77995-3938
Mailing Address - Country:US
Mailing Address - Phone:361-741-2051
Mailing Address - Fax:
Practice Address - Street 1:115 MEDICAL DR STE 105
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77904-3105
Practice Address - Country:US
Practice Address - Phone:361-575-2882
Practice Address - Fax:361-574-9710
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX606132363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX606132OtherFAMILY NURSE PRACTITIONER
TXB113334Medicare PIN