Healthcare Provider Details

I. General information

NPI: 1982214615
Provider Name (Legal Business Name): BERNITA VEREEN PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2020
Last Update Date: 05/10/2024
Certification Date: 05/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2645 MERIDIAN PKWY STE 323
DURHAM NC
27713-4232
US

IV. Provider business mailing address

3803 N ELM ST
GREENSBORO NC
27455-2593
US

V. Phone/Fax

Practice location:
  • Phone: 657-237-2450
  • Fax:
Mailing address:
  • Phone: 336-934-4333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number5013299
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: