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Desarae Lateva Jefferson
Private Vehicle in Hurt, Virginia
NPI 1114559077

Desarae Lateva Jefferson is a Private Vehicle based in Hurt, VA. Desarae Lateva Jefferson practices in Hurt, VA. The NPI Number for Desarae Lateva Jefferson is 1114559077 and holds a License No. T60727635 (Virginia).

The current practice location address for Desarae Lateva Jefferson is 4357 Roark Mill Rd, Hurt, VA and can be reached out via phone at 434-420-8823 and via fax at 434-324-0568.

Location: 4357 Roark Mill Rd, Hurt, VA, 24563-3308
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1114559077
Provider Name
Desarae Lateva Jefferson
Credential
Provider Entity Type
Individual
Gender
Female
Address
4357 Roark Mill Rd, Hurt, VA, 24563-3308
Phone Number
434-420-8823
Fax Number
434-324-0568
Provider Enumeration Date
02/10/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
4357 Roark Mill Rd
City
Hurt
State
Virginia
Zip
24563-3308
Phone Number
434-420-8823
Fax Number
434-324-0568
person
Provider Business Mailing Address Details
Address
4357 Roark Mill Rd
City
Hurt
State
Virginia
Zip
24563-3308
Phone Number
434-420-8823
Fax Number
434-324-0568
person
Provider's Taxonomy Details 1
Type
Transportation Services
Classification
Private Vehicle
Speciality
-
Taxonomy
347C00000X
License No.
T60727635 (Virginia)
Definition
An individual paid to provide non-emergency transportation using their privately owned/leased vehicle.
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