Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DESARAE LATEVA JEFFERSON
Active Sole ProprietorDESARAE LATEVA JEFFERSON is a Private Vehicle healthcare provider located in HURT, Virginia. NPI 1114559077 is currently active in the NPPES registry. Verify at CMS.
Private Vehicle · HURT, VA
Registration Details
- NPI Number
- 1114559077
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Feb 10, 2020 (6.4841064416875 yrs)
- Last Updated
- Feb 10, 2020
- License
-
T60727635 (VA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
4357 ROARK MILL RDHURT, VA, 245633308Browse VA providers · Browse ZIP 24563
- Phone
- 4344208823
- Fax
- 4343240568
- Primary Specialty
-
Private Vehicle
347C00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.