Provider Demographics
NPI:1285899146
Name:VANDEVELDE, ELIZABETH ANN (ANP-C)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ANN
Last Name:VANDEVELDE
Suffix:
Gender:F
Credentials:ANP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 BATTY WAY
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29154-8156
Mailing Address - Country:US
Mailing Address - Phone:803-607-9070
Mailing Address - Fax:
Practice Address - Street 1:129 NORTH WASHINGTON
Practice Address - Street 2:TUOMEY HEALTHCARE SYSTEM
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29152
Practice Address - Country:US
Practice Address - Phone:803-774-5248
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-21
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9413942363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC54-04286OtherSC DHEC
A0796043OtherAMERICAN ACADEMY OF NURSE PRACTITIONERS
SC4286OtherSC LLR
SC4286OtherSC LLR