Provider Demographics
NPI:1760077044
Name:BITHOS, DEVONA NICOLE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:DEVONA
Middle Name:NICOLE
Last Name:BITHOS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MISS
Other - First Name:DEVONA
Other - Middle Name:NICOLE
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:1481 W 10TH ST # A-6107
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-2803
Mailing Address - Country:US
Mailing Address - Phone:317-988-9708
Mailing Address - Fax:
Practice Address - Street 1:1481 W 10TH ST # A-6107
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-2803
Practice Address - Country:US
Practice Address - Phone:317-988-9708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-08
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71010951A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily