MEDICARE: VANESSA DOAN APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	81595	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	81595	OTHER	KS	KANSAS LICENSE

General Provider Information

NPI Number	:	1356066252
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VANESSA DOAN APRN

Provider Business Mailing Address
First Line	:	1021 FLEMING ST
Second Line	:
City	:	GARDEN CITY
State	:	KS
Zip	:	67846-6252
Country	:	US
Telephone Number	:	620-287-2010
Fax Number	:	620-260-9900

Provider Business Practice Location Address
First Line	:	1021 FLEMING ST
Second Line	:
City	:	GARDEN CITY
State	:	KS
Zip	:	67846-6252
Country	:	US
Telephone Number	:	620-287-2010
Fax Number	:	620-260-9900

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2022
Last Update Date	:	05/16/2024

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Directions to “ VANESSA DOAN APRN” Practice Location

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