Basic Information
| Provider Information | |||||||||
| NPI: | 1952404295 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FIELDS | ||||||||
| FirstName: | VERA | ||||||||
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| Credential: | BSN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1050 RIBAUT RD | ||||||||
| Address2: | |||||||||
| City: | BEAUFORT | ||||||||
| State: | SC | ||||||||
| PostalCode: | 299025400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8435243378 | ||||||||
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| Practice Location | |||||||||
| Address1: | 65 FORREST DRIVE | ||||||||
| Address2: | |||||||||
| City: | VARNVILLE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 29944 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8039432828 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/05/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP0808X | 62140 | SC | Y | Nursing Service Providers | Registered Nurse | Psych/Mental Health |
No ID Information.