Provider Demographics
NPI:1578077848
Name:NYE, DEVON (FNP)
Entity Type:Individual
Prefix:
First Name:DEVON
Middle Name:
Last Name:NYE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:329 BLUEBONNET CIR
Mailing Address - Street 2:
Mailing Address - City:MC GREGOR
Mailing Address - State:TX
Mailing Address - Zip Code:76657-9510
Mailing Address - Country:US
Mailing Address - Phone:254-717-7626
Mailing Address - Fax:
Practice Address - Street 1:120 HILLCREST MEDICAL BLVD STE 200
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-8950
Practice Address - Country:US
Practice Address - Phone:254-297-0400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-25
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX803417363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics