Provider Demographics
NPI:1295889665
Name:'ANDERSON, VERA ROSE (APRN, BC, CS)
Entity type:Individual
Prefix:MRS
First Name:VERA
Middle Name:ROSE
Last Name:'ANDERSON
Suffix:
Gender:F
Credentials:APRN, BC, CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 347
Mailing Address - Street 2:
Mailing Address - City:KERNVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:93238-0347
Mailing Address - Country:US
Mailing Address - Phone:760-376-3662
Mailing Address - Fax:
Practice Address - Street 1:2731 NUGGET AVE
Practice Address - Street 2:
Practice Address - City:LAKE ISABELLA
Practice Address - State:CA
Practice Address - Zip Code:93240-2632
Practice Address - Country:US
Practice Address - Phone:760-379-3412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA199429163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health