Provider Demographics
NPI:1033700224
Name:ARCHER, VERONICA ELAINE
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:ELAINE
Last Name:ARCHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:238 BULL RUN DR
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL
Mailing Address - State:VA
Mailing Address - Zip Code:23860-4000
Mailing Address - Country:US
Mailing Address - Phone:804-446-0028
Mailing Address - Fax:804-895-7901
Practice Address - Street 1:238 BULL RUN DR
Practice Address - Street 2:
Practice Address - City:HOPEWELL
Practice Address - State:VA
Practice Address - Zip Code:23860-4000
Practice Address - Country:US
Practice Address - Phone:804-631-1105
Practice Address - Fax:804-895-7901
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-29
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator