Provider Demographics
NPI:1740002542
Name:PRICE, VANESSA AMANDA (APRN-CNP)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:AMANDA
Last Name:PRICE
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5334
Mailing Address - Street 2:
Mailing Address - City:GRANBURY
Mailing Address - State:TX
Mailing Address - Zip Code:76049-0334
Mailing Address - Country:US
Mailing Address - Phone:817-326-3440
Mailing Address - Fax:817-910-9421
Practice Address - Street 1:2006 FALL CREEK HWY
Practice Address - Street 2:
Practice Address - City:GRANBURY
Practice Address - State:TX
Practice Address - Zip Code:76049-7913
Practice Address - Country:US
Practice Address - Phone:817-326-3440
Practice Address - Fax:817-940-9421
Is Sole Proprietor?:No
Enumeration Date:2024-10-31
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1179270363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily