Provider Demographics
NPI:1962045716
Name:CURL, VANESSA MICHELLE (CPHT)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:MICHELLE
Last Name:CURL
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 MAPLE DR
Mailing Address - Street 2:
Mailing Address - City:VIDALIA
Mailing Address - State:GA
Mailing Address - Zip Code:30474-8908
Mailing Address - Country:US
Mailing Address - Phone:912-538-0053
Mailing Address - Fax:912-538-0498
Practice Address - Street 1:305 MAPLE DR
Practice Address - Street 2:
Practice Address - City:VIDALIA
Practice Address - State:GA
Practice Address - Zip Code:30474-8908
Practice Address - Country:US
Practice Address - Phone:912-538-0053
Practice Address - Fax:912-538-0498
Is Sole Proprietor?:No
Enumeration Date:2019-10-24
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA10090836183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician