Healthcare Provider Details

I. General information

NPI: 1811433063
Provider Name (Legal Business Name): VANESA RAMIREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2017
Last Update Date: 01/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 MEMORIAL DRIVE # 9135
CULLOWHEE NC
28723
US

IV. Provider business mailing address

245 MEMORIAL DRIVE # 9135
CULLOWHEE NC
28723
US

V. Phone/Fax

Practice location:
  • Phone: 828-575-4660
  • Fax:
Mailing address:
  • Phone: 828-575-4660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number39465404
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number39465404
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: