Provider Demographics
NPI:1679054092
Name:DEVENS, KRISTINE EVE (CPM, LM, EMT)
Entity Type:Individual
Prefix:MRS
First Name:KRISTINE
Middle Name:EVE
Last Name:DEVENS
Suffix:
Gender:F
Credentials:CPM, LM, EMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:629 HICKMAN DR
Mailing Address - Street 2:
Mailing Address - City:SAUK CENTRE
Mailing Address - State:MN
Mailing Address - Zip Code:56378-1809
Mailing Address - Country:US
Mailing Address - Phone:320-304-3253
Mailing Address - Fax:
Practice Address - Street 1:13 2ND ST N
Practice Address - Street 2:
Practice Address - City:LONG PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:56347-1117
Practice Address - Country:US
Practice Address - Phone:320-732-8162
Practice Address - Fax:320-732-8161
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-23
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1070176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife