Anderson, Devon Nicole

Anderson, Devon Nicole is an individual health care provider with primary practice located at 4700 S Washington St Ste G , Grand Forks ND 58201-8123. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Anderson, Devon Nicole can be contacted via phone (701) 205-3000.

Contact Information

Primary practice address
4700 S Washington St Ste G Grand Forks ND 58201-8123
Phone: (701) 205-3000
Fax: (701) 732-2501
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 13224 Minnesota
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 153663 Alaska
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X Utah
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PAC0802 North Dakota

Profile Details

NPI number 1023663598
LBN Legal business name Anderson, Devon Nicole
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 1st, 2019
Last updated Jan 7th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023663598 NPPES
North Dakota MEDICAID 1478558

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