Provider Demographics
NPI:1932249307
Name:DEAN, VANESSA GAIL
Entity Type:Individual
Prefix:MRS
First Name:VANESSA
Middle Name:GAIL
Last Name:DEAN
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 1:128 WREXHAM CT S
Mailing Address - Street 2:
Mailing Address - City:TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14150-8814
Mailing Address - Country:US
Mailing Address - Phone:716-254-4198
Mailing Address - Fax:
Practice Address - Street 1:128 WREXHAM CT S
Practice Address - Street 2:
Practice Address - City:TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14150-8814
Practice Address - Country:US
Practice Address - Phone:716-254-4198
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2010-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY266687164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse