Provider Demographics
NPI:1568209401
Name:HANSON, VANESSA E (CPT)
Entity type:Individual
Prefix:MS
First Name:VANESSA
Middle Name:E
Last Name:HANSON
Suffix:
Gender:F
Credentials:CPT
Other - Prefix:
Other - First Name:VANESSA
Other - Middle Name:ELIZABETH
Other - Last Name:HANSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:555 EXPRESSWAY DR APT 62
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37355-2702
Mailing Address - Country:US
Mailing Address - Phone:931-952-5647
Mailing Address - Fax:844-463-7146
Practice Address - Street 1:555 EXPRESSWAY DR APT 62
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:TN
Practice Address - Zip Code:37355-2702
Practice Address - Country:US
Practice Address - Phone:931-952-5647
Practice Address - Fax:844-463-7146
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-09
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID2014-ID432246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy