Healthcare Provider Details

I. General information

NPI: 1720526270
Provider Name (Legal Business Name): VANESSA M VENTURA CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2017
Last Update Date: 01/22/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 COLLYER ST STE 302
PROVIDENCE RI
02904-1869
US

IV. Provider business mailing address

195 COLLYER ST STE 302
PROVIDENCE RI
02904-1869
US

V. Phone/Fax

Practice location:
  • Phone: 401-270-7710
  • Fax: 401-793-5171
Mailing address:
  • Phone: 401-270-7710
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN2306192
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN01690
License Number StateRI
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN2306192
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: