| Doctor Name: | MR. THOMAS ARTHUR DEVINE |
| NPI Number: | 1548627516 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | FNP |
| License Number: | 95003680 |
| Business Practice Address: | 284 Spruce St Gridley, CA - 959482216 |
| Business Phone Number: | 5308469080 |
| Business Fax Number: | 5308465708 |
| Mailing Address: | 9066 Ida St, LIVE OAK |
| State: | CA |
| Postal Code: | 959532822 |
| Phone Number: | 3606213932 |
| Fax Number: | 5308465708 |
| NPI Enumeration Date: | 01/21/2016 |
| NPI Last Update Date: | 01/21/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 95003680 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |