Provider Demographics
NPI:1922577352
Name:DEVOE, MARY M
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:M
Last Name:DEVOE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2316 N 11TH ST
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47804-2319
Mailing Address - Country:US
Mailing Address - Phone:812-821-5326
Mailing Address - Fax:
Practice Address - Street 1:2316 N 11TH ST
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47804-2319
Practice Address - Country:US
Practice Address - Phone:812-821-5326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-14
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion