Provider Demographics
NPI:1366968984
Name:VENEY, LEVERNIA
Entity type:Individual
Prefix:
First Name:LEVERNIA
Middle Name:
Last Name:VENEY
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:PO BOX 1376
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:VA
Mailing Address - Zip Code:22572-1376
Mailing Address - Country:US
Mailing Address - Phone:804-456-6044
Mailing Address - Fax:
Practice Address - Street 1:12554 HISTORY LAND HWY
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:VA
Practice Address - Zip Code:22572-3234
Practice Address - Country:US
Practice Address - Phone:804-456-6044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-15
Last Update Date:2017-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver