Individual
GEORGE VANAGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AGNP-C
Contact information
Practice address
2424 S 90TH ST STE 502, WEST ALLIS, WI 53227-2455
(414) 773-4312
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(414) 219-2000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
10163
WI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
10163
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100140417
—
WI
Enumeration date
06/30/2020
Last updated
04/11/2025
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