Provider Demographics
NPI:1336429588
Name:CAPPS, VANESSA L (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:VANESSA
Middle Name:L
Last Name:CAPPS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:VANESSA
Other - Middle Name:L
Other - Last Name:COFFMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3400 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HOPKINS PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60944
Mailing Address - Country:US
Mailing Address - Phone:815-944-5545
Mailing Address - Fax:815-944-6723
Practice Address - Street 1:3400 S MAIN ST
Practice Address - Street 2:
Practice Address - City:HOPKINS PARK
Practice Address - State:IL
Practice Address - Zip Code:60944
Practice Address - Country:US
Practice Address - Phone:815-944-5545
Practice Address - Fax:815-944-6723
Is Sole Proprietor?:No
Enumeration Date:2011-08-19
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.008974363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily