Provider Demographics
NPI:1326028861
Name:MCPHERSON, VELDA LISE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:VELDA
Middle Name:LISE
Last Name:MCPHERSON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:961 SCARLET OAK RD
Mailing Address - Street 2:
Mailing Address - City:BLYTHEWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29016-5818
Mailing Address - Country:US
Mailing Address - Phone:254-630-8735
Mailing Address - Fax:
Practice Address - Street 1:220 STONERIDGE DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29210-8018
Practice Address - Country:US
Practice Address - Phone:254-630-8735
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX141718164W00000X
SC28215A363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No164W00000XNursing Service ProvidersLicensed Practical Nurse