Basic Information
Provider Information | |||||||||
NPI: | 1235551516 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | SMALHEISER | ||||||||
FirstName: | VERONICA | ||||||||
MiddleName: | KEM | ||||||||
NamePrefix: | MRS. | ||||||||
NameSuffix: |   | ||||||||
Credential: | NP-C, ANP-BC, CCRN | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | SCHIRNER | ||||||||
OtherFirstName: | VERONICA | ||||||||
OtherMiddleName: | KEM | ||||||||
OtherNamePrefix: | MISS | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: | RN | ||||||||
OtherLastNameType: | 1 | ||||||||
Mailing Information | |||||||||
Address1: | 300 MIDTOWN DR | ||||||||
Address2: |   | ||||||||
City: | BEAUFORT | ||||||||
State: | SC | ||||||||
PostalCode: | 299065200 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8437700404 | ||||||||
FaxNumber: | 8437700006 | ||||||||
Practice Location | |||||||||
Address1: | 300 MIDTOWN DR | ||||||||
Address2: |   | ||||||||
City: | BEAUFORT | ||||||||
State: | SC | ||||||||
PostalCode: | 299065200 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8437700404 | ||||||||
FaxNumber: | 8437700006 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 01/06/2014 | ||||||||
LastUpdateDate: | 09/17/2015 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 18359 | SC | Y |   | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |   | 363LA2200X | 18359 | SC | N |   | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health | 363LG0600X | 18359 | SC | N |   | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Gerontology |
No ID Information.