Provider Demographics
NPI:1346684586
Name:VEGAS, ANNE-MARIE (PA-C)
Entity Type:Individual
Prefix:
First Name:ANNE-MARIE
Middle Name:
Last Name:VEGAS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:991 ELLISTON WAY
Mailing Address - Street 2:
Mailing Address - City:THOMPSONS STATION
Mailing Address - State:TN
Mailing Address - Zip Code:37179-9801
Mailing Address - Country:US
Mailing Address - Phone:615-257-3436
Mailing Address - Fax:615-257-3437
Practice Address - Street 1:991 ELLISTON WAY
Practice Address - Street 2:
Practice Address - City:THOMPSONS STATION
Practice Address - State:TN
Practice Address - Zip Code:37179-9801
Practice Address - Country:US
Practice Address - Phone:615-257-3436
Practice Address - Fax:615-257-3437
Is Sole Proprietor?:No
Enumeration Date:2013-04-18
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC5-0000871363A00000X
TN3327363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant