Provider Demographics
NPI:1841883618
Name:ALBAN, VANESSA ALEXANDRA (APRN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:ALEXANDRA
Last Name:ALBAN
Suffix:
Gender:F
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7418 MICHIGAN ISLE RD
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-7789
Mailing Address - Country:US
Mailing Address - Phone:954-478-7079
Mailing Address - Fax:
Practice Address - Street 1:1903 S CONGRESS AVE STE 455
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-6559
Practice Address - Country:US
Practice Address - Phone:954-478-7079
Practice Address - Fax:949-561-5955
Is Sole Proprietor?:No
Enumeration Date:2021-02-12
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11009186363L00000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner