Provider Demographics
NPI:1417667502
Name:VASQUEZ, ADDIE (CD)
Entity Type:Individual
Prefix:
First Name:ADDIE
Middle Name:
Last Name:VASQUEZ
Suffix:
Gender:F
Credentials:CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7333 FALL CREEK LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-4310
Mailing Address - Country:US
Mailing Address - Phone:337-466-5484
Mailing Address - Fax:
Practice Address - Street 1:7333 FALL CREEK LN
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-4310
Practice Address - Country:US
Practice Address - Phone:337-466-5484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-29
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula