Doctor Name: | NAOMI DEVINE |
NPI Number: | 1073932513 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | AP5391 |
Business Practice Address: | 2788 E Desert Rose Trl San Tan Valley, AZ - 851434642 |
Business Phone Number: | 5135203263 |
Business Fax Number: | |
Mailing Address: | 2788 E Desert Rose Trl, SAN TAN VALLEY |
State: | AZ |
Postal Code: | 851434642 |
Phone Number: | 5135203263 |
Fax Number: | |
NPI Enumeration Date: | 04/14/2014 |
NPI Last Update Date: | 04/14/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | AP5391 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |