Healthcare Provider Details

I. General information

NPI: 1992658330
Provider Name (Legal Business Name): VANE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2026
Last Update Date: 02/17/2026
Certification Date: 02/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1736 E SUNSHINE ST STE LL7
SPRINGFIELD MO
65804-1326
US

IV. Provider business mailing address

1736 E SUNSHINE ST STE LL7
SPRINGFIELD MO
65804-1326
US

V. Phone/Fax

Practice location:
  • Phone: 417-204-5118
  • Fax: 414-204-1703
Mailing address:
  • Phone: 417-204-5118
  • Fax: 414-204-1703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State

VIII. Authorized Official

Name: VLADIMIR LOUISJEUNE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 417-204-5118