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General NPI Number Information
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NPI Number | 1972187995
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Entity Type | Organization
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Legal Business Name | KACYE M VANN NURSE PRACTITIONER
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Dates
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Enumeration Date | 05/06/2021
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Last Update Date | 06/27/2025
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Provider Practice Location Address
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Address Line | 903 E BROADWAY ST
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City | GAINESVILLE
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State | TX
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Zip | 76240-4235
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Country | US
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Telephone | 940-336-4584
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Fax |
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Provider Business Mailing Address
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Address Line | 903 E BROADWAY ST
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City | GAINESVILLE
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State | TX
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Zip | 76240-4235
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Country | US
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Telephone | 940-641-3440
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Fax | 800-979-3142
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Authorized Official
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Title or Position | NURSE PRACTITIONER / OWNER
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Name | KACYE M VANN
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Credential | FNP
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Telephone | 940-641-3440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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