Provider Demographics
NPI:1467687384
Name:DEVORE, ALICIA DENISE (APRN, CDE, FNP-BC)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:DENISE
Last Name:DEVORE
Suffix:
Gender:F
Credentials:APRN, CDE, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46354 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:OH
Mailing Address - Zip Code:43718-9637
Mailing Address - Country:US
Mailing Address - Phone:740-213-0015
Mailing Address - Fax:
Practice Address - Street 1:2115 CHAPLINE ST STE 206
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-3859
Practice Address - Country:US
Practice Address - Phone:304-234-3410
Practice Address - Fax:304-234-8605
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-20
Last Update Date:2019-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVAPRN71268363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily