Provider Demographics
NPI:1053654442
Name:COLLINS, VANESSA JANE (FNP)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:JANE
Last Name:COLLINS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:VANESSA
Other - Middle Name:JANE
Other - Last Name:CARTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:3901 RAINBOW BLVD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160
Mailing Address - Country:US
Mailing Address - Phone:913-945-6739
Mailing Address - Fax:913-588-2061
Practice Address - Street 1:3901 RAINBOW BLVD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160
Practice Address - Country:US
Practice Address - Phone:913-945-6739
Practice Address - Fax:913-588-2061
Is Sole Proprietor?:No
Enumeration Date:2013-04-03
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013012076363LF0000X
MOF0313228364SF0001X
KS53-82078-032363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health