Provider Demographics
NPI:1811433063
Name:RAMIREZ, VANESA
Entity type:Individual
Prefix:
First Name:VANESA
Middle Name:
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 MEMORIAL DRIVE
Mailing Address - Street 2:# 9135
Mailing Address - City:CULLOWHEE
Mailing Address - State:NC
Mailing Address - Zip Code:28723
Mailing Address - Country:US
Mailing Address - Phone:828-575-4660
Mailing Address - Fax:
Practice Address - Street 1:245 MEMORIAL DRIVE
Practice Address - Street 2:# 9135
Practice Address - City:CULLOWHEE
Practice Address - State:NC
Practice Address - Zip Code:28723
Practice Address - Country:US
Practice Address - Phone:828-575-4660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-12
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC394654042255A2300X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer