Provider Demographics
NPI:1639862527
Name:ABACAN, VANESSA ALINSUB (DNP, RNC-MNN, EBP-C)
Entity Type:Individual
Prefix:DR
First Name:VANESSA
Middle Name:ALINSUB
Last Name:ABACAN
Suffix:
Gender:F
Credentials:DNP, RNC-MNN, EBP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10307 ARMSTRONG DR
Mailing Address - Street 2:
Mailing Address - City:ROSHARON
Mailing Address - State:TX
Mailing Address - Zip Code:77583-1330
Mailing Address - Country:US
Mailing Address - Phone:281-709-8309
Mailing Address - Fax:
Practice Address - Street 1:10307 ARMSTRONG DR
Practice Address - Street 2:
Practice Address - City:ROSHARON
Practice Address - State:TX
Practice Address - Zip Code:77583-1330
Practice Address - Country:US
Practice Address - Phone:281-709-8309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-29
Last Update Date:2023-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX837344364SP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPediatrics