Provider Demographics
NPI:1053425991
Name:VERONEE, ELIZABETH J (PA-C)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:J
Last Name:VERONEE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1241 WOODLAND AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464
Mailing Address - Country:US
Mailing Address - Phone:843-824-0606
Mailing Address - Fax:843-824-0909
Practice Address - Street 1:1241 WOODLAND AVE
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464
Practice Address - Country:US
Practice Address - Phone:843-824-0606
Practice Address - Fax:843-824-0909
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC0262PAMedicaid
SCS704661709Medicare ID - Type Unspecified
SC0262PAMedicaid