Provider Demographics
NPI:1891520995
Name:CHRISTIAN, VANESSA RENEE (FNP-C)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:RENEE
Last Name:CHRISTIAN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:VANESSA
Other - Middle Name:RENEE
Other - Last Name:WOODARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:154 SAINT CLAIR DR
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:GA
Mailing Address - Zip Code:31763-3225
Mailing Address - Country:US
Mailing Address - Phone:404-729-8154
Mailing Address - Fax:
Practice Address - Street 1:154 SAINT CLAIR DR
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:GA
Practice Address - Zip Code:31763-3225
Practice Address - Country:US
Practice Address - Phone:404-729-8154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-06
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN296839363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily