Provider Demographics
NPI:1053966242
Name:GEIS, DEVYN LOCKLEY (PA-C)
Entity type:Individual
Prefix:
First Name:DEVYN
Middle Name:LOCKLEY
Last Name:GEIS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:DEVYN
Other - Middle Name:MARIE
Other - Last Name:LOCKLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 96911
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28296-6911
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1025 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-7354
Practice Address - Country:US
Practice Address - Phone:910-762-3882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-05
Last Update Date:2025-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-09183363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant