Provider Demographics
NPI:1437404456
Name:PIKE, VEDA RAE (CNA)
Entity type:Individual
Prefix:MS
First Name:VEDA
Middle Name:RAE
Last Name:PIKE
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 HOME ALONE
Mailing Address - Street 2:
Mailing Address - City:BYLAS
Mailing Address - State:AZ
Mailing Address - Zip Code:85530
Mailing Address - Country:US
Mailing Address - Phone:928-961-0797
Mailing Address - Fax:
Practice Address - Street 1:318 HOME ALONE
Practice Address - Street 2:
Practice Address - City:BYLAS
Practice Address - State:AZ
Practice Address - Zip Code:85530
Practice Address - Country:US
Practice Address - Phone:928-961-0797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-16
Last Update Date:2012-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor