Provider Demographics
NPI:1881431203
Name:ACOSTA, VANESSA EVE (APRN)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:EVE
Last Name:ACOSTA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 K ST NE APT 1312
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-6698
Mailing Address - Country:US
Mailing Address - Phone:978-382-1992
Mailing Address - Fax:
Practice Address - Street 1:3020 14TH ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-6865
Practice Address - Country:US
Practice Address - Phone:202-469-4699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-12
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCNP500018695363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health