Individual
VICTORIA JEAN VANACORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
790 W POPLAR AVE, COLLIERVILLE, TN 38017-2544
(901) 853-9700
(901) 245-4244
Mailing address
790 W POPLAR AVE, COLLIERVILLE, TN 38017-2544
(901) 853-9700
(901) 245-4244
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3386
TN
363A00000X
Physician Assistant
PA9106248
FL
363AS0400X
Surgical Physician Assistant
PA9106248
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016646600
—
FL
01
—
1242841
WELLCARE
FL
01
—
398528
AVMED
FL
01
—
5359596
CIGNA
FL
01
—
9422829
AETNA
FL
01
—
P01584470
RR MEDICARE
FL
01
—
P1032516
FREEDOM
FL
01
—
P968867
OPTIMUM
FL
01
—
YJAAL
BCBS
FL
Enumeration date
10/20/2011
Last updated
03/31/2026
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