Provider Demographics
NPI:1851568141
Name:KNOWLES, VANESSA DONITA (ARNP)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:DONITA
Last Name:KNOWLES
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:VANESSA
Other - Middle Name:DONITA
Other - Last Name:INTERIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:4500 S 129TH EAST AVE STE 191
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74134-5891
Mailing Address - Country:US
Mailing Address - Phone:800-993-8244
Mailing Address - Fax:
Practice Address - Street 1:1500 W UNIVERSITY PKWY
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243-2217
Practice Address - Country:US
Practice Address - Phone:941-362-1294
Practice Address - Fax:855-481-9771
Is Sole Proprietor?:No
Enumeration Date:2008-05-15
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3170312363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner