Provider Demographics
NPI:1396238218
Name:FLANNERY, VANESSA (DNP, APRN)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:FLANNERY
Suffix:
Gender:F
Credentials:DNP, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:GRAYSON
Mailing Address - State:KY
Mailing Address - Zip Code:41143-1014
Mailing Address - Country:US
Mailing Address - Phone:606-225-8200
Mailing Address - Fax:
Practice Address - Street 1:207 N CAROL MALONE BLVD STE 3
Practice Address - Street 2:
Practice Address - City:GRAYSON
Practice Address - State:KY
Practice Address - Zip Code:41143-1566
Practice Address - Country:US
Practice Address - Phone:606-225-8200
Practice Address - Fax:888-606-7354
Is Sole Proprietor?:No
Enumeration Date:2018-06-14
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3012414363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily