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NPI Code Detail

MEDICARE: DEZARAE VERRETT

MEDICARE: DEZARAE VERRETT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1253Z00000XIn Home Supportive Care AgencyIN

General Provider Information

NPI Number : 1568324044
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEZARAE VERRETT
Provider Business Mailing Address
First Line : 2601 KAY ELLEN DR
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46229-1236
Country : US
Telephone Number : 317-946-1807
Fax Number :
Provider Business Practice Location Address
First Line : 2601 KAY ELLEN DR
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46229-1236
Country : US
Telephone Number : 317-946-1807
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2025
Last Update Date : 12/02/2025

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Directions to “ DEZARAE VERRETT ” Practice Location

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