Provider Demographics
NPI:1982293825
Name:ALBERSON, DEVIN LEE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:DEVIN
Middle Name:LEE
Last Name:ALBERSON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:DEVIN
Other - Middle Name:
Other - Last Name:NOVAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 781076
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48278-4827
Mailing Address - Country:US
Mailing Address - Phone:317-528-4800
Mailing Address - Fax:317-865-1479
Practice Address - Street 1:1205 S MAIN ST STE 201
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-3677
Practice Address - Country:US
Practice Address - Phone:219-663-6520
Practice Address - Fax:219-757-6436
Is Sole Proprietor?:No
Enumeration Date:2021-01-14
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209021724363LA2100X
IN71014247A363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care