Provider Demographics
NPI:1225312192
Name:VIERELA, ANNE (CNM)
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:
Last Name:VIERELA
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3440
Mailing Address - Street 2:
Mailing Address - City:MURRELLS INLET
Mailing Address - State:SC
Mailing Address - Zip Code:29576-2674
Mailing Address - Country:US
Mailing Address - Phone:843-357-5022
Mailing Address - Fax:843-357-5035
Practice Address - Street 1:4017 BYPASS 17
Practice Address - Street 2:SUITE 100
Practice Address - City:MURRELLS INLET
Practice Address - State:SC
Practice Address - Zip Code:29576
Practice Address - Country:US
Practice Address - Phone:843-357-5022
Practice Address - Fax:843-357-5035
Is Sole Proprietor?:No
Enumeration Date:2011-10-10
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11340367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP0739Medicaid
SCGP0739Medicaid