Provider Demographics
NPI:1205696382
Name:DUBOSE, VERA KATHARINA (APRN)
Entity type:Individual
Prefix:
First Name:VERA
Middle Name:KATHARINA
Last Name:DUBOSE
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:VERA
Other - Middle Name:KATHARINA
Other - Last Name:BUECHEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:708 MEDICAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:HARTSVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29550-4765
Mailing Address - Country:US
Mailing Address - Phone:843-332-5121
Mailing Address - Fax:843-332-0993
Practice Address - Street 1:708 MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:HARTSVILLE
Practice Address - State:SC
Practice Address - Zip Code:29550-4765
Practice Address - Country:US
Practice Address - Phone:843-332-5121
Practice Address - Fax:843-332-0993
Is Sole Proprietor?:No
Enumeration Date:2024-03-19
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC246566163WC0200X
SC28862363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine