Provider Demographics
NPI:1942408570
Name:BRISCOE, VANESSA JONES (APRN, BC)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:JONES
Last Name:BRISCOE
Suffix:
Gender:F
Credentials:APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3331 TORRE BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW SMYRNA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32168-4689
Mailing Address - Country:US
Mailing Address - Phone:615-554-0530
Mailing Address - Fax:
Practice Address - Street 1:5111 S RIDGEWOOD AVE STE 2008
Practice Address - Street 2:
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32127-5176
Practice Address - Country:US
Practice Address - Phone:386-256-3466
Practice Address - Fax:386-238-9239
Is Sole Proprietor?:No
Enumeration Date:2007-07-05
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9374796163WG0000X
FLAPRN9374796363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice