Provider Demographics
NPI:1790191120
Name:VANEPPS, CHEVON NICOLE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:CHEVON
Middle Name:NICOLE
Last Name:VANEPPS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 ELM ST
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48706-4055
Mailing Address - Country:US
Mailing Address - Phone:989-793-4420
Mailing Address - Fax:
Practice Address - Street 1:4177 FASHION SQUARE BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-5216
Practice Address - Country:US
Practice Address - Phone:989-791-9100
Practice Address - Fax:989-791-6746
Is Sole Proprietor?:No
Enumeration Date:2014-07-07
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704250472363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily