Provider Demographics
NPI:1235938374
Name:HERRERA, VANESSA
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:HERRERA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1012 GRISHAM DR
Mailing Address - Street 2:
Mailing Address - City:GIBBON
Mailing Address - State:NE
Mailing Address - Zip Code:68840-3007
Mailing Address - Country:US
Mailing Address - Phone:209-292-9972
Mailing Address - Fax:
Practice Address - Street 1:1012 GRISHAM DR
Practice Address - Street 2:
Practice Address - City:GIBBON
Practice Address - State:NE
Practice Address - Zip Code:68840-3007
Practice Address - Country:US
Practice Address - Phone:209-292-9972
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant