Provider Demographics
NPI:1396328647
Name:DESROCHES-MCDEVITT, DOREEN MARIE
Entity type:Individual
Prefix:
First Name:DOREEN
Middle Name:MARIE
Last Name:DESROCHES-MCDEVITT
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 1:9100 VANCE ST APT 113
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80021-7012
Mailing Address - Country:US
Mailing Address - Phone:720-456-0702
Mailing Address - Fax:
Practice Address - Street 1:9100 VANCE ST APT 113
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80021-7012
Practice Address - Country:US
Practice Address - Phone:720-456-0702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-04
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider