Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 44511 | TN |
NPI | 1063569945 |
---|---|
Provider Name | Jessica K Devin |
First Address | Loveland, CO 80538-9071 |
Second Address | Steamboat Springs, CO 80487 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2007 |
Last Update Date | 19/09/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1512570 | (05) | TN |
44511 | STATE MEDICAL LICENSE (01) | TN |