Provider Demographics
NPI:1942508411
Name:VANESSA SANNE RN CFNP LLC
Entity type:Organization
Organization Name:VANESSA SANNE RN CFNP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN, FNP-C
Authorized Official - Prefix:
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:KATHLEEN
Authorized Official - Last Name:SANNE
Authorized Official - Suffix:
Authorized Official - Credentials:RN, FNP-C
Authorized Official - Phone:503-356-2385
Mailing Address - Street 1:1338 SE 61ST PL
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-6789
Mailing Address - Country:US
Mailing Address - Phone:503-356-2385
Mailing Address - Fax:
Practice Address - Street 1:527 SE BASELINE ST
Practice Address - Street 2:SUITE G
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-4149
Practice Address - Country:US
Practice Address - Phone:503-941-9129
Practice Address - Fax:503-941-9132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-08
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201050213NP261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care