Individual
PHYLLIS VANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
10748 VIRGINIA PLZ, SUITE 107, LAVISTA, NE 68128-3265
(402) 933-4411
(888) 507-5931
Mailing address
10748 VIRGINIA PLZ, SUITE 107, LAVISTA, NE 68128-3265
(402) 933-4411
(888) 507-5931
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
113743
NE
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
3012687
KY
Other
Enumeration date
09/18/2018
Last updated
02/22/2022
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