Healthcare Provider Details

I. General information

NPI: 1285567727
Provider Name (Legal Business Name): NH VCN VIRTUAL PRIMARY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 HOSPITAL DR
MT PLEASANT SC
29464-3764
US

IV. Provider business mailing address

PO BOX 604509
CHARLOTTE NC
28260-4509
US

V. Phone/Fax

Practice location:
  • Phone: 980-217-2025
  • Fax: 980-598-8251
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: LEEA JEANINE WALTON
Title or Position: RCS MANAGER
Credential:
Phone: 704-316-6081