Provider Demographics
NPI:1548060106
Name:BRUSH, DEVON (FNP-C)
Entity type:Individual
Prefix:
First Name:DEVON
Middle Name:
Last Name:BRUSH
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3710 WABASH AVE APT 120
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92104-3963
Mailing Address - Country:US
Mailing Address - Phone:209-404-8226
Mailing Address - Fax:
Practice Address - Street 1:3710 WABASH AVE APT 120
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92104-3963
Practice Address - Country:US
Practice Address - Phone:209-404-8226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95034383363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily