Provider Demographics
NPI:1932665817
Name:VEAL, SERLENIA
Entity Type:Individual
Prefix:MRS
First Name:SERLENIA
Middle Name:
Last Name:VEAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 LAVERNE CIR SW
Mailing Address - Street 2:
Mailing Address - City:MILLEDGEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31061-4402
Mailing Address - Country:US
Mailing Address - Phone:478-457-4104
Mailing Address - Fax:
Practice Address - Street 1:154 LAVERNE CIR SW
Practice Address - Street 2:
Practice Address - City:MILLEDGEVILLE
Practice Address - State:GA
Practice Address - Zip Code:31061-4402
Practice Address - Country:US
Practice Address - Phone:478-457-4104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-14
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver