Provider Demographics
NPI:1437286432
Name:CARTER-SMITH, VERONDA K (FNP)
Entity Type:Individual
Prefix:
First Name:VERONDA
Middle Name:K
Last Name:CARTER-SMITH
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:VERONDA
Other - Middle Name:KAYE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP
Mailing Address - Street 1:1 CALIFORNIA ST STE 2300
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94111-5424
Mailing Address - Country:US
Mailing Address - Phone:800-997-6196
Mailing Address - Fax:415-504-1367
Practice Address - Street 1:1 CALIFORNIA ST STE 2300
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94111-5424
Practice Address - Country:US
Practice Address - Phone:800-997-6196
Practice Address - Fax:415-504-1367
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61350277363L00000X
IAA163213363L00000X
CO109764363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
015407OtherKAISER-COMMERCIAL NUMBER
015407OtherKAISER-COMMERCIAL NUMBER
COQ22986Medicare UPIN
COC547718Medicare PIN
015407OtherKAISER-COMMERCIAL NUMBER