Provider Demographics
NPI:1710123427
Name:VRAIN, MANON GABRIELLE (NP)
Entity type:Individual
Prefix:MISS
First Name:MANON
Middle Name:GABRIELLE
Last Name:VRAIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3355 CHAD DR
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97408-7428
Mailing Address - Country:US
Mailing Address - Phone:541-607-7459
Mailing Address - Fax:760-967-4450
Practice Address - Street 1:3355 CHAD DR
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97408-7428
Practice Address - Country:US
Practice Address - Phone:541-607-7459
Practice Address - Fax:541-607-7573
Is Sole Proprietor?:No
Enumeration Date:2008-12-30
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA74533163WC1500X
CA95021318363LA2200X
CA724402163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health