Provider Demographics
NPI:1922622919
Name:RAYFORD, DEVONTEE DELISHUANEE (DNP CRNA)
Entity Type:Individual
Prefix:
First Name:DEVONTEE
Middle Name:DELISHUANEE
Last Name:RAYFORD
Suffix:
Gender:F
Credentials:DNP CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3925 CRENSHAW AVE
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76105-4115
Mailing Address - Country:US
Mailing Address - Phone:682-554-0080
Mailing Address - Fax:
Practice Address - Street 1:3925 CRENSHAW AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76105-4115
Practice Address - Country:US
Practice Address - Phone:682-554-0080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-04
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD127535367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered