Provider Demographics
NPI:1609615954
Name:VANDA, BRITT NOELLE (FNP)
Entity type:Individual
Prefix:
First Name:BRITT
Middle Name:NOELLE
Last Name:VANDA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:BRITT
Other - Middle Name:NOELLE
Other - Last Name:LOWRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2308 NOTTINGHAM DR
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-9183
Mailing Address - Country:US
Mailing Address - Phone:715-781-3691
Mailing Address - Fax:
Practice Address - Street 1:85 E US HIGHWAY 6
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-8947
Practice Address - Country:US
Practice Address - Phone:219-983-6680
Practice Address - Fax:219-983-6080
Is Sole Proprietor?:No
Enumeration Date:2024-05-24
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN7105386A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily