Provider Demographics
NPI:1669576922
Name:ALTMAN, VANNA THI (FNP)
Entity type:Individual
Prefix:
First Name:VANNA
Middle Name:THI
Last Name:ALTMAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:955 MAIN ST STE G6
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01890-1992
Mailing Address - Country:US
Mailing Address - Phone:781-729-4878
Mailing Address - Fax:781-729-5989
Practice Address - Street 1:955 MAIN ST STE G6
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:MA
Practice Address - Zip Code:01890-1992
Practice Address - Country:US
Practice Address - Phone:781-729-4878
Practice Address - Fax:781-598-8136
Is Sole Proprietor?:No
Enumeration Date:2006-09-08
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA252422163W00000X
MARN252422363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse