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Individual
VANDA N ESME
Active
Individual
VANDA N ESME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209-007586
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
041315170
—
IL
01
—
F400124677
PTAN
—
Enumeration date
07/01/2009
Last updated
03/02/2015
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