Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Vedalie Souvenance, NP

Individual provider Adult Health Nurse Practitioner · NPI 1407455884

Vedalie Souvenance, NP is a Nurse Practitioner in Queens Village, New York. Qualified in 2023, 3 years ago. Practices with Ilm Medical Care PLLC, a 37-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
3
Licensed in
NY
In the registry since
2020
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

See every abbreviation used in this directory →

Practice location Address checks out

21229 Hillside Ave Apt 3JE
Queens Village, NY 11427-1851
Phone: (917) 825-0930
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence F311426-01 (NY)

Record details

NPI number1407455884
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP
Sole proprietorNo
NPI enumeratedOctober 18, 2020
Last updated in NPPESNovember 19, 2024
Certification dateNovember 19, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Ilm Medical Care Pllc — 37 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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