Maureen Vancura, NP
Individual provider Active NPI Family Nurse Practitioner · Williamson, NY
NPI 1245302546 · NPPES record last updated Apr 20, 2011
Key facts
- NPI
- 1245302546
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 330465 (NY)
- Practice address
- 4425 Old Ridge Rd
The Commons
Williamson, NY 14589-9363 - Phone
- (315) 483-3220
- Fax
- (315) 589-4893
- NPI assigned
- Nov 14, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 330465 | NY | Yes |
Addresses
Primary practice location
4425 Old Ridge Rd
The Commons
Williamson, NY 14589-9363
Mailing address
4425 Old Ridge Rd
PO Box 934
Williamson, NY 14589-9363
Phone (315) 483-3220
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03300869 | Medicaid | NY |
Other providers in Williamson, NY
- James F Stohr
- Dana Stratton
- Dorene A Strommer
- Tricia Swartz
- Kelli Ann Swingly
- Maritza Guadalupe Vargas-Perez
- Walgreen Co
- Carlton Walker
- Jan M Walker
- Ingrid M. Wander
All providers in Williamson, NY · Family Nurse Practitioner in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 20, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.