Provider Demographics
NPI:1508749565
Name:QUENTIN, VANESSA ANN
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:ANN
Last Name:QUENTIN
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 1:140 CROWNE CHASE DR APT 5
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27104-3581
Mailing Address - Country:US
Mailing Address - Phone:414-731-4307
Mailing Address - Fax:
Practice Address - Street 1:2554 LEWISVILLE CLEMMONS RD STE 209
Practice Address - Street 2:
Practice Address - City:CLEMMONS
Practice Address - State:NC
Practice Address - Zip Code:27012-8749
Practice Address - Country:US
Practice Address - Phone:336-660-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant