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General NPI Number Information
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NPI Number | 1528529708
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Entity Type | Individual
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Provider Name | COURTNEY MARIE VANCE MD
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Gender | Female
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Dates
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Enumeration Date | 03/28/2019
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Last Update Date | 10/23/2024
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Provider Practice Location Address
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Address Line | 2770 CAPITAL MEDICAL BLVD
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City | TALLAHASSEE
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State | FL
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Zip | 32308-8417
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Country | US
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Telephone | 850-391-3880
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Fax | 833-450-6214
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Provider Business Mailing Address
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Address Line | 3621 MOLLY PITCHER CT
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City | TALLAHASSEE
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State | FL
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Zip | 32308-4000
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Country | US
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Telephone | 210-837-0584
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | ME157061
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | TRN29432
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License Number State | FL
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