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MRS. SUE LILLIAN DEVERS RN
>> Registered Nurse >> Nursing Service ProvidersRegistrant NPI Number: 1407178957
Individual Registrant:MRS. SUE LILLIAN DEVERS RN
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
3449 E REZANOF DR KODIAK, AK 99615 US
Tel: 907-486-9870 Fax: 907-486-9897
Tel: 907-486-9870 Fax: 907-486-9897
Contact information for business:
3449 E REZANOF DR KODIAK, AK 99615 US
Tel: 907-486-9870 Fax: 907-486-9897
Tel: 907-486-9870 Fax: 907-486-9897
Registration Information:
NPI: 1407178957
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 163W00000X | Nursing Service Providers Registered Nurse | AK | 4497 |
| Y | 208D00000X | Allopathic & Osteopathic Physicians General Practice | AK | 4497 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| CL3225 | AK | 05 |
