Provider Demographics
NPI:1093476541
Name:VERSTER, LORI
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:VERSTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1322 AVENUE I
Mailing Address - Street 2:
Mailing Address - City:GOTHENBURG
Mailing Address - State:NE
Mailing Address - Zip Code:69138-1815
Mailing Address - Country:US
Mailing Address - Phone:308-537-3651
Mailing Address - Fax:866-430-5324
Practice Address - Street 1:1322 AVENUE I
Practice Address - Street 2:
Practice Address - City:GOTHENBURG
Practice Address - State:NE
Practice Address - Zip Code:69138-1815
Practice Address - Country:US
Practice Address - Phone:308-537-3651
Practice Address - Fax:866-430-5324
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-06
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)