Provider Demographics
NPI:1316229388
Name:DEVRIES, ELIZABETH (APRN)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:
Last Name:DEVRIES
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17929 HUNTING BOW CIR
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33558-5378
Mailing Address - Country:US
Mailing Address - Phone:813-792-8555
Mailing Address - Fax:813-792-0555
Practice Address - Street 1:17929 HUNTING BOW CIR
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33558-5378
Practice Address - Country:US
Practice Address - Phone:813-792-8555
Practice Address - Fax:813-792-0555
Is Sole Proprietor?:No
Enumeration Date:2011-09-15
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11003501363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily