Provider Demographics
NPI:1528833407
Name:DEVOE, LORENNA L
Entity type:Individual
Prefix:
First Name:LORENNA
Middle Name:L
Last Name:DEVOE
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:PO BOX 186
Mailing Address - Street 2:
Mailing Address - City:ESMOND
Mailing Address - State:ND
Mailing Address - Zip Code:58332-0186
Mailing Address - Country:US
Mailing Address - Phone:541-404-2375
Mailing Address - Fax:
Practice Address - Street 1:107 ALTA AVE N
Practice Address - Street 2:
Practice Address - City:ESMOND
Practice Address - State:ND
Practice Address - Zip Code:58332-3203
Practice Address - Country:US
Practice Address - Phone:154-140-4237
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty