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NPI Code Detail

MEDICARE: VASTI ORTEGA GEDDES PMHNP-BC

MEDICARE: VASTI ORTEGA GEDDES PMHNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse PractitionerPENDINGSC

General Provider Information

NPI Number : 1306732631
Entity Type Code : Individual
Provider Name (Legal Business Name) : VASTI ORTEGA GEDDES PMHNP-BC
Provider Business Mailing Address
First Line : 135 AQUINAS WAY
Second Line :
City : ROCK HILL
State : SC
Zip : 29730-0180
Country : US
Telephone Number : 910-441-8054
Fax Number :
Provider Business Practice Location Address
First Line : 1188 STONECREST BLVD STE 110
Second Line :
City : FORT MILL
State : SC
Zip : 29708-6633
Country : US
Telephone Number : 803-233-3236
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2025
Last Update Date : 06/16/2025

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Directions to “ VASTI ORTEGA GEDDES PMHNP-BC” Practice Location

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