Provider Demographics
NPI:1073815445
Name:DEVECE, WILLIAM G (CRNA)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:G
Last Name:DEVECE
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 650782
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75265-0782
Mailing Address - Country:US
Mailing Address - Phone:215-442-5085
Mailing Address - Fax:215-672-4264
Practice Address - Street 1:701 N. CLAYTON ST.
Practice Address - Street 2:4TH FLOOR
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-3155
Practice Address - Country:US
Practice Address - Phone:302-421-4330
Practice Address - Fax:302-421-4331
Is Sole Proprietor?:No
Enumeration Date:2010-11-17
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN602279367500000X
DEL6-0A00604367500000X
NJ26NJ00308900367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered