Provider Demographics
NPI:1679212377
Name:STEVERSON, VARSHA NICOLE
Entity Type:Individual
Prefix:
First Name:VARSHA
Middle Name:NICOLE
Last Name:STEVERSON
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 1:301 CHAPEL HILL RD
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:GA
Mailing Address - Zip Code:31816-6111
Mailing Address - Country:US
Mailing Address - Phone:706-987-3153
Mailing Address - Fax:
Practice Address - Street 1:301 CHAPEL HILL RD
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:GA
Practice Address - Zip Code:31816-6111
Practice Address - Country:US
Practice Address - Phone:706-987-3153
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-01
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor