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General NPI Number Information
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NPI Number | 1114483906
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Entity Type | Individual
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Provider Name | VANESSA JILL LEVINE NP
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Gender | Female
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Dates
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Enumeration Date | 02/16/2019
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Last Update Date | 09/10/2024
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Provider Practice Location Address
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Address Line | 407 CAPE CORAL PKWY W
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City | CAPE CORAL
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State | FL
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Zip | 33914-6521
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Country | US
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Telephone | 239-376-0800
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Fax |
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Provider Business Mailing Address
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Address Line | 4105 W RIVERSIDE DR
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City | FORT MYERS
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State | FL
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Zip | 33901-8732
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Country | US
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Telephone | 269-501-4613
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN270524
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 11007563
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License Number State | FL
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