Provider Demographics
NPI:1144625716
Name:STOKES, VANESSA LAPRICE
Entity type:Individual
Prefix:MISS
First Name:VANESSA
Middle Name:LAPRICE
Last Name:STOKES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 MARVIN CV
Mailing Address - Street 2:
Mailing Address - City:HUTTO
Mailing Address - State:TX
Mailing Address - Zip Code:78634-5186
Mailing Address - Country:US
Mailing Address - Phone:518-763-6770
Mailing Address - Fax:
Practice Address - Street 1:250 MARVIN CV
Practice Address - Street 2:
Practice Address - City:HUTTO
Practice Address - State:TX
Practice Address - Zip Code:78634-5186
Practice Address - Country:US
Practice Address - Phone:518-763-6770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-24
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY919909071171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor