MEDICARE: MRS. VERONICA INKLEY HIS

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
1	237700000X	Hearing Instrument Specialist	2101002500	VA

General Provider Information

NPI Number	:	1538707690
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. VERONICA INKLEY HIS

Provider Business Mailing Address
First Line	:	385 GARRISONVILLE RD STE 121
Second Line	:
City	:	STAFFORD
State	:	VA
Zip	:	22554-8900
Country	:	US
Telephone Number	:	540-318-8604
Fax Number	:

Provider Business Practice Location Address
First Line	:	385 GARRISONVILLE RD STE 121
Second Line	:
City	:	STAFFORD
State	:	VA
Zip	:	22554-8900
Country	:	US
Telephone Number	:	540-318-8604
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/19/2019
Last Update Date	:	01/03/2024

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