Provider Demographics
NPI:1598361099
Name:DUCKETT, VERONICA DENISE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:VERONICA
Middle Name:DENISE
Last Name:DUCKETT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:328 STEELMAN DR
Mailing Address - Street 2:
Mailing Address - City:INMAN
Mailing Address - State:SC
Mailing Address - Zip Code:29349-7720
Mailing Address - Country:US
Mailing Address - Phone:864-205-2184
Mailing Address - Fax:
Practice Address - Street 1:93 HUMAN SERVICES RD
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:SC
Practice Address - Zip Code:29325-7546
Practice Address - Country:US
Practice Address - Phone:864-883-0100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-09
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC30572164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse