Provider Demographics
NPI:1598461014
Name:VAN ESS, VANESSA GRACE (BSN RN, RCS)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:GRACE
Last Name:VAN ESS
Suffix:
Gender:F
Credentials:BSN RN, RCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 LAUREL DR
Mailing Address - Street 2:
Mailing Address - City:FRANCIS CREEK
Mailing Address - State:WI
Mailing Address - Zip Code:54214-9132
Mailing Address - Country:US
Mailing Address - Phone:920-973-6148
Mailing Address - Fax:
Practice Address - Street 1:427 LAUREL DR
Practice Address - Street 2:
Practice Address - City:FRANCIS CREEK
Practice Address - State:WI
Practice Address - Zip Code:54214-9132
Practice Address - Country:US
Practice Address - Phone:920-973-6148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI264948163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse