Provider Demographics
NPI:1063035988
Name:DEVLIN, MICHELE KATHLEEN (DRPH, EMT)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:KATHLEEN
Last Name:DEVLIN
Suffix:
Gender:F
Credentials:DRPH, EMT
Other - Prefix:
Other - First Name:MICHELE
Other - Middle Name:
Other - Last Name:FIVES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:300 STATE ST UNIT 110
Mailing Address - Street 2:
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-3342
Mailing Address - Country:US
Mailing Address - Phone:319-939-1452
Mailing Address - Fax:
Practice Address - Street 1:300 STATE ST UNIT 110
Practice Address - Street 2:
Practice Address - City:CEDAR FALLS
Practice Address - State:IA
Practice Address - Zip Code:50613-3342
Practice Address - Country:US
Practice Address - Phone:319-939-1452
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-27
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAE343214146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic