Provider Demographics
NPI:1578206991
Name:LLOYD, VANESSA ANN (RN)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:ANN
Last Name:LLOYD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:456 MARKET PLACE MALL STE B
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:WV
Mailing Address - Zip Code:26452-6964
Mailing Address - Country:US
Mailing Address - Phone:304-516-3674
Mailing Address - Fax:
Practice Address - Street 1:456 MARKET PLACE MALL STE B
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:WV
Practice Address - Zip Code:26452-6964
Practice Address - Country:US
Practice Address - Phone:304-516-3674
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-14
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV50140163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse