Vanessa Acosta

Individual provider Active NPI Driver · Stony Creek, VA

NPI 1861935447 · NPPES record last updated Sep 4, 2024

Key facts

NPI
1861935447
Entity type
Individual (NPI type 1)
Primary specialty
Driver 172A00000X
License
T62577598 (VA)
Practice address
17326 Winfield LN
Stony Creek, VA 23882-3522
Phone
(804) 704-2640
NPI assigned
Nov 30, 2016
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)
No

State licenses

LicenseStateTypeSpecialty
T62577598VAMDDriver

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Driver 172A00000X T62577598 VA Yes

Addresses

Primary practice location

17326 Winfield LN
Stony Creek, VA 23882-3522

Mailing address

17326 Winfield LN
Stony Creek, VA 23882-3522
Phone (804) 704-2640

Other providers in Stony Creek, VA

All providers in Stony Creek, VA · Driver in Virginia

Sources for this page

Verify at the official NPI Registry.