Provider Demographics
NPI:1407622855
Name:YOUNG, VANESSA SHOTTS (APRN, FNP-C)
Entity Type:Individual
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First Name:VANESSA
Middle Name:SHOTTS
Last Name:YOUNG
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Gender:F
Credentials:APRN, FNP-C
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Mailing Address - Street 1:960 MASSACHUSETTS AVENUE
Mailing Address - Street 2:FL 2
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:830 HARRISON AVE
Practice Address - Street 2:MOAKLEY BUILDING SUITE 3500
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118
Practice Address - Country:US
Practice Address - Phone:617-638-8776
Practice Address - Fax:617-414-8772
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-28
Last Update Date:2024-03-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MARN2311480363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily