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General NPI Number Information
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NPI Number | 1023933397
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Entity Type | Individual
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Provider Name | MRS. VANESSA BADGER
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Gender | Female
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Dates
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Enumeration Date | 08/13/2026
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Last Update Date | 08/13/2026
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Provider Practice Location Address
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Address Line | 168 14 ST W
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City | FAIRFAX
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State | SC
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Zip | 29827-5704
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Country | US
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Telephone | 839-204-2056
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Fax | 839-204-2030
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Provider Business Mailing Address
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Address Line | PO BOX 1456
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City | FAIRFAX
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State | SC
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Zip | 29827-1456
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Country | US
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Telephone | 839-204-2056
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Fax | 839-204-2030
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | SC
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