VANESSA WADSWORTH


Address: 10726 Ketchum Valley Dr, Riverview, FL 33579-7185
Phone: 8136779200

VANESSA WADSWORTH (NPI# 1356819882) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1356819882
Entity Type Individual
Full Name VANESSA WADSWORTH
Credential APRN-BC
Practice Address 10726 Ketchum Valley Dr
Riverview
FL 33579-7185
Practice Telephone 8136779200
Mailing Telephone 8136779200
Enumeration Date 2018-11-02
Last Update Date 2018-11-02
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LA2200X Nurse Practitioner
Specialization: Adult Health
9313260 FL Physician Assistants & Advanced Practice Nursing Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
119 Oakfield Dr, Brandon, FL 335115779 8136815551

Office Location

Street Address 10726 KETCHUM VALLEY DR
City RIVERVIEW
State FL
Zip Code 33579-7185

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Taxonomy Information

Taxonomy Code 363LA2200X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Adult Health

Taxonomy Definition

Definition to come...

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NPI Name Taxonomy Address Enumeration
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1730280611 Melissa Mcallister Hutton Nurse Practitioner 6223 Watermark Dr, Apt. 104, Riverview, FL 33578-3977 2006-09-26
1376564195 Tish I'renee Carlton Nurse Practitioner 10634 Shady Preserve Dr, Riverview, FL 33579-9310 2006-07-21
1699199000 Cecilia Meg O'connor Nurse Practitioner 19020 Fort St, Riverview, MI 48193-6701 2014-02-06

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Competitor

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City RIVERVIEW
Zip Code 33579

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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