Provider Demographics
NPI:1013791268
Name:FRIDLEY, DEVAN (APRN, DNP)
Entity type:Individual
Prefix:MS
First Name:DEVAN
Middle Name:
Last Name:FRIDLEY
Suffix:
Gender:F
Credentials:APRN, DNP
Other - Prefix:MS
Other - First Name:DEVAN
Other - Middle Name:
Other - Last Name:WEATHERFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 100129
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0129
Mailing Address - Country:US
Mailing Address - Phone:352-265-5470
Mailing Address - Fax:352-627-4173
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-3003
Practice Address - Country:US
Practice Address - Phone:352-265-5470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-21
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11029193363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care