Provider Demographics
NPI:1144761693
Name:VERSE-HARDING, DEVONE
Entity Type:Individual
Prefix:
First Name:DEVONE
Middle Name:
Last Name:VERSE-HARDING
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4029 KEASBERRY AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89081-6693
Mailing Address - Country:US
Mailing Address - Phone:708-205-7066
Mailing Address - Fax:
Practice Address - Street 1:4029 KEASBERRY AVE
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89081-6693
Practice Address - Country:US
Practice Address - Phone:708-205-7066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-16
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner