Healthcare Provider Details

I. General information

NPI: 1154465680
Provider Name (Legal Business Name): EDWARD JOSEPH DEVERGES III R.N.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 REYNOLDS PL
ASHEVILLE NC
28804-2330
US

IV. Provider business mailing address

16 REYNOLDS PL
ASHEVILLE NC
28804-2330
US

V. Phone/Fax

Practice location:
  • Phone: 828-252-5980
  • Fax:
Mailing address:
  • Phone: 828-252-5980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License Number091406
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number091406
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: