Basic Information
| Provider Information | |||||||||
| NPI: | 1295889665 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | 'ANDERSON | ||||||||
| FirstName: | VERA | ||||||||
| MiddleName: | ROSE | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | APRN, BC, CS | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 347 | ||||||||
| Address2: | |||||||||
| City: | KERNVILLE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 932380347 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7603763662 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2731 NUGGET AVE | ||||||||
| Address2: | |||||||||
| City: | LAKE ISABELLA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 932402632 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7603793412 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/23/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP0808X | 199429 | CA | Y | Nursing Service Providers | Registered Nurse | Psych/Mental Health |
No ID Information.