Individual
MICHAEL VERVILLE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Contact information
Practice address
216 ANAMARIA DR, RAPID CITY, SD 57701-7366
(605) 721-0337
(605) 721-0043
Mailing address
311 E LIBERTY ST, RAPID CITY, SD 57701-7668
(605) 343-4730
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R027222
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5752153
—
SD
Enumeration date
09/13/2005
Last updated
07/08/2007
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