Provider Demographics
NPI:1649759242
Name:PREYER, DEEVONA MICHELLE (RN)
Entity Type:Individual
Prefix:MISS
First Name:DEEVONA
Middle Name:MICHELLE
Last Name:PREYER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 ROMA
Mailing Address - Street 2:
Mailing Address - City:CIBOLO
Mailing Address - State:TX
Mailing Address - Zip Code:78108-3900
Mailing Address - Country:US
Mailing Address - Phone:910-257-5175
Mailing Address - Fax:
Practice Address - Street 1:605 ROMA
Practice Address - Street 2:
Practice Address - City:CIBOLO
Practice Address - State:TX
Practice Address - Zip Code:78108-3900
Practice Address - Country:US
Practice Address - Phone:910-257-5175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-14
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX947557163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse