Individual
VANESSA VANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
710 CARLTON DR, OWENSBORO, KY 42303-7719
(270) 240-4892
Mailing address
1217 HUMPHREY ST, HARTFORD, KY 42347-1610
(270) 240-4892
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1699148007
—
KY
Enumeration date
11/06/2015
Last updated
03/28/2017
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