Individual
VANESSA LYNN DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
662 N MAIN ST, SPRINGBORO, OH 45066-9553
(937) 641-5066
(937) 550-9797
Mailing address
PO BOX 933432, CLEVELAND, OH 44193-0039
(937) 641-3000
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
APRN.CNP.13836
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0073866
—
OH
Enumeration date
09/12/2012
Last updated
02/17/2026
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