Individual
VERONICA S. WACTOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2401 SUNSET BLVD, WEST COLUMBIA, SC 29169-4717
(866) 389-2727
(401) 652-9787
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4023
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AA46545925
MEDICARE PTAN
SC
Enumeration date
12/11/2009
Last updated
07/12/2021
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