Provider Demographics
NPI:1659177210
Name:JEAN-LOUIS, VANESSA
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:JEAN-LOUIS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1021 SE MONTEREY RD APT A26
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-4568
Mailing Address - Country:US
Mailing Address - Phone:772-900-6845
Mailing Address - Fax:772-324-5812
Practice Address - Street 1:1021 SE MONTEREY RD APT A26
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-4568
Practice Address - Country:US
Practice Address - Phone:772-900-6845
Practice Address - Fax:772-324-5812
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171100000X, 172V00000X, 175F00000X
FL000000000202D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturist
No172V00000XOther Service ProvidersCommunity Health Worker
No202D00000XAllopathic & Osteopathic PhysiciansIntegrative Medicine