Provider Demographics
NPI:1710457098
Name:CARDONA, VANESSA ALYS (WHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:VANESSA
Middle Name:ALYS
Last Name:CARDONA
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2824 CENTRAL DR STE 332
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021-7819
Mailing Address - Country:US
Mailing Address - Phone:817-545-0077
Mailing Address - Fax:817-685-7952
Practice Address - Street 1:7424 GREENVILLE AVE STE 206
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4534
Practice Address - Country:US
Practice Address - Phone:720-450-8524
Practice Address - Fax:855-716-3447
Is Sole Proprietor?:No
Enumeration Date:2018-11-29
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXAP143906363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health