Provider Demographics
NPI:1205861333
Name:SALYER, VANESSA T (FNP)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:T
Last Name:SALYER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:VANESSA
Other - Middle Name:T
Other - Last Name:GENTRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1021 W OAKLAND AVE STE 310
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-2192
Mailing Address - Country:US
Mailing Address - Phone:423-952-2111
Mailing Address - Fax:423-282-1657
Practice Address - Street 1:98 15TH ST NW STE 207A
Practice Address - Street 2:
Practice Address - City:NORTON
Practice Address - State:VA
Practice Address - Zip Code:24273-1600
Practice Address - Country:US
Practice Address - Phone:276-679-0321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2024-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN15465363LF0000X
VA0024166926363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1205861333Medicaid
TN103I504413Medicare PIN
VAVV1166BMedicare PIN
TN103I509247Medicare PIN
VAVV1166AMedicare PIN