Provider Demographics
NPI:1356851398
Name:LEVERETTE, VANESSA DICKEY (CD(DONA))
Entity Type:Individual
Prefix:MRS
First Name:VANESSA
Middle Name:DICKEY
Last Name:LEVERETTE
Suffix:
Gender:F
Credentials:CD(DONA)
Other - Prefix:MS
Other - First Name:VANESSA
Other - Middle Name:
Other - Last Name:DICKEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CD(DONA)
Mailing Address - Street 1:802 STAUNTON BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29611
Mailing Address - Country:US
Mailing Address - Phone:864-386-6587
Mailing Address - Fax:
Practice Address - Street 1:802 STAUNTON BRIDGE RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29611
Practice Address - Country:US
Practice Address - Phone:864-386-6587
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-04
Last Update Date:2017-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11475374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula