Vanessa Ashley Kinney, FNP-C

Individual provider Active NPI Family Nurse Practitioner · Olanta, SC

NPI 1992356232 · NPPES record last updated May 8, 2024

Key facts

NPI
1992356232
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
22990 (SC)
Practice address
211 S Jones Rd
Olanta, SC 29114-9705
Phone
(843) 396-9730
Fax
(843) 396-9735
NPI assigned
Sep 27, 2019
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20201116001445 SC Practitioner - Nurse Practitioner 5991116311

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
22990SCMDFamily Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 22990 SC Yes

Addresses

Primary practice location

211 S Jones Rd
Olanta, SC 29114-9705

Mailing address

8906 Two Notch Rd
Columbia, SC 29223-6366
Phone (803) 254-3676

Other identifiers

IdentifierTypeStateIssuer
NP7213MedicaidSC

Other names

  • Vanessa Ashley Baggett Former name

Other providers in Olanta, SC

All providers in Olanta, SC · Family Nurse Practitioner in South Carolina

Sources for this page

Verify at the official NPI Registry.