Provider Demographics
NPI:1932419066
Name:VANAKEN, LOIS E (FNP)
Entity Type:Individual
Prefix:MRS
First Name:LOIS
Middle Name:E
Last Name:VANAKEN
Suffix:
Gender:F
Credentials:FNP
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1250 SISKIYOU BLVD
Mailing Address - Street 2:SOU STUDENT HEALTH & WELLNESS CENTER
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520
Mailing Address - Country:US
Mailing Address - Phone:541-552-6136
Mailing Address - Fax:541-552-6693
Practice Address - Street 1:1250 SISKIYOU BLVD
Practice Address - Street 2:SOU STUDENT HEALTH & WELLNESS CENTER
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520
Practice Address - Country:US
Practice Address - Phone:541-552-6136
Practice Address - Fax:541-552-6693
Is Sole Proprietor?:No
Enumeration Date:2010-10-07
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OR083045257N1363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner