Provider Demographics
NPI:1821432899
Name:DRIVER, DEVON ELIZABETH (FNP-BC)
Entity Type:Individual
Prefix:
First Name:DEVON
Middle Name:ELIZABETH
Last Name:DRIVER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:DEVON
Other - Middle Name:ELIZABETH
Other - Last Name:NELSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:220 GRACES WAY
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229-1613
Mailing Address - Country:US
Mailing Address - Phone:803-736-4560
Mailing Address - Fax:803-744-1217
Practice Address - Street 1:220 GRACES WAY
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29229-1613
Practice Address - Country:US
Practice Address - Phone:803-736-4560
Practice Address - Fax:803-744-1217
Is Sole Proprietor?:No
Enumeration Date:2013-04-22
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN218402363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily