Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
VANISA EZUKUSE, M.D.
DeactivatedVANISA EZUKUSE, M.D. is a Student (Health Education/Training) healthcare provider located in SAINT LOUIS, Missouri. NPI 1720880024 is deactivated in the NPPES registry. Verify at CMS.
Student (Health Education/Training) · SAINT LOUIS, MO
This NPI has been deactivated.
The record was deactivated on October 27, 2025.
Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated.
Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.
Registration Details
- NPI Number
- 1720880024
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Mar 26, 2025 (0.58904109589041 yrs)
- Last Updated
- Nov 26, 2025
- Deactivated
- Oct 27, 2025
Practice Information
- Address
-
1201 SOUTH GRAND BLVDSAINT LOUIS, MO, 63104Browse MO providers · Browse ZIP 63104
- Phone
- 3142578000
- Fax
- 3149771664
- Primary Specialty
-
Student (Health Education/Training)
390200000X
Other Student (Health Education/Training) Providers in SAINT LOUIS, MO
| Name | Credential | NPI |
|---|---|---|
| MRS. DEBORAH IBORG | ATC | 1265407332 |
| DR. ALAN IRWIN GLASS | M.D. | 1568506145 |
| DR. ARSHAD BHATT | M.D. | 1215138698 |
| MICHAEL J OMBRELLO | M.D. | 1235330515 |
| DR. JULIE ADAMS | D.O. | 1720280639 |
| DR. JAMES MATTHEW TAYLOR | M.D. | 1720281140 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.