Doctor Name: | MS. ASHLEY BETH DEVRIES |
NPI Number: | 1023077997 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | P.A.-C |
License Number: | PA 9103557 |
Business Practice Address: | 1606 Tennessee Ave Lynn Haven, FL - 324443653 |
Business Phone Number: | 8502653606 |
Business Fax Number: | 8502710400 |
Mailing Address: | 1606 Tennessee Ave, LYNN HAVEN |
State: | FL |
Postal Code: | 324443653 |
Phone Number: | 8502653606 |
Fax Number: | 8502710400 |
NPI Enumeration Date: | 03/20/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | PA 9103557 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |