Individual provider · Type 1 NPI

Desarae Lateva Jefferson

Private Vehicle · Hurt, VA

NPI number 1114559077 Active

Practice location

4357 Roark Mill Rd
Hurt, VA 24563-3308

Call (434) 420-8823 Map

Fax (434) 324-0568

Specialties and licenses

TaxonomyCodeLicense
Private Vehicle Primary 347C00000XT60727635 (VA)

Private Vehicle: An individual paid to provide non-emergency transportation using their privately owned/leased vehicle.

About NPI 1114559077

Desarae Lateva Jefferson's National Provider Identifier is 1114559077, issued on Feb 10, 2020. The primary taxonomy on file is Private Vehicle (347C00000X), and the practice location is in Hurt, VA. The record was last updated on Feb 10, 2020.