Provider Demographics
NPI:1356066252
Name:DOAN, VANESSA (APRN)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:DOAN
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 1:1021 FLEMING ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67846-6252
Mailing Address - Country:US
Mailing Address - Phone:620-287-2010
Mailing Address - Fax:620-260-9900
Practice Address - Street 1:1021 FLEMING ST
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:KS
Practice Address - Zip Code:67846-6252
Practice Address - Country:US
Practice Address - Phone:620-287-2010
Practice Address - Fax:620-260-9900
Is Sole Proprietor?:No
Enumeration Date:2022-10-04
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS81595363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS81595OtherKANSAS LICENSE