Provider Demographics
NPI:1790067536
Name:DEVEREAUX, JANE S (CNA)
Entity Type:Individual
Prefix:MRS
First Name:JANE
Middle Name:S
Last Name:DEVEREAUX
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 W COLUMBIA AVE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37917-5304
Mailing Address - Country:US
Mailing Address - Phone:865-356-7426
Mailing Address - Fax:
Practice Address - Street 1:217 W COLUMBIA AVE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37917-5304
Practice Address - Country:US
Practice Address - Phone:865-356-7426
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-19
Last Update Date:2011-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide