Provider Demographics
NPI:1831758788
Name:JAMES, VENUS NICOLE (APRN)
Entity type:Individual
Prefix:
First Name:VENUS
Middle Name:NICOLE
Last Name:JAMES
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:VENUS
Other - Middle Name:NICOLE
Other - Last Name:WIRTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 917770
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32891-0001
Mailing Address - Country:US
Mailing Address - Phone:813-821-8038
Mailing Address - Fax:813-974-0483
Practice Address - Street 1:12530 USF BULLS RUN DRIVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33620-2653
Practice Address - Country:US
Practice Address - Phone:813-821-8038
Practice Address - Fax:813-974-0483
Is Sole Proprietor?:No
Enumeration Date:2019-06-12
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11002126363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL109751300Medicaid
FL4PKHDOtherBLUE CROSS BLUE SHIELD