Provider Demographics
NPI:1598511966
Name:VP MINDCARE
Entity type:Organization
Organization Name:VP MINDCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:VANJA
Authorized Official - Middle Name:
Authorized Official - Last Name:PUMPALOVIC
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:615-939-9391
Mailing Address - Street 1:1837 AMESBURY LN
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37221-2531
Mailing Address - Country:US
Mailing Address - Phone:615-939-9391
Mailing Address - Fax:
Practice Address - Street 1:205 E BENSON BLVD STE 519
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-4019
Practice Address - Country:US
Practice Address - Phone:907-215-0820
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-26
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty