Provider Demographics
NPI:1619197704
Name:DEVENY, SANDRA KAY (NP)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:KAY
Last Name:DEVENY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:SANDRA
Other - Middle Name:KAY
Other - Last Name:RUSSO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:232 W BELL ST
Mailing Address - Street 2:
Mailing Address - City:WINNEMUCCA
Mailing Address - State:NV
Mailing Address - Zip Code:89445-3702
Mailing Address - Country:US
Mailing Address - Phone:775-267-7628
Mailing Address - Fax:775-996-0775
Practice Address - Street 1:232 W BELL ST
Practice Address - Street 2:
Practice Address - City:WINNEMUCCA
Practice Address - State:NV
Practice Address - Zip Code:89445-3702
Practice Address - Country:US
Practice Address - Phone:775-267-7628
Practice Address - Fax:775-996-0775
Is Sole Proprietor?:No
Enumeration Date:2007-04-30
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPN000620363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily