Provider Demographics
NPI:1164770970
Name:VASSEY, JUNE ANNETTE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:JUNE
Middle Name:ANNETTE
Last Name:VASSEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4179 STONE STATION RD
Mailing Address - Street 2:
Mailing Address - City:ROEBUCK
Mailing Address - State:SC
Mailing Address - Zip Code:29376-3624
Mailing Address - Country:US
Mailing Address - Phone:864-670-0070
Mailing Address - Fax:
Practice Address - Street 1:5895 REIDVILLE RD
Practice Address - Street 2:
Practice Address - City:MOORE
Practice Address - State:SC
Practice Address - Zip Code:29369-8409
Practice Address - Country:US
Practice Address - Phone:864-486-6990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-28
Last Update Date:2015-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCAPN.17923 APRN363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily