Provider Demographics
NPI:1891803938
Name:VANIEA, ANNE WILTSIE (RN)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:WILTSIE
Last Name:VANIEA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1544
Mailing Address - Street 2:
Mailing Address - City:LAGRANDE
Mailing Address - State:OR
Mailing Address - Zip Code:97850-6544
Mailing Address - Country:US
Mailing Address - Phone:541-403-0367
Mailing Address - Fax:
Practice Address - Street 1:2810 N DEPOT
Practice Address - Street 2:
Practice Address - City:LAGRANDE
Practice Address - State:OR
Practice Address - Zip Code:97850-6544
Practice Address - Country:US
Practice Address - Phone:541-403-0367
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health