Provider Demographics
NPI:1942044631
Name:STUBBLEFIELD, DEVON (RN)
Entity type:Individual
Prefix:
First Name:DEVON
Middle Name:
Last Name:STUBBLEFIELD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13621 MAPLE LEAF DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-3136
Mailing Address - Country:US
Mailing Address - Phone:501-259-5919
Mailing Address - Fax:
Practice Address - Street 1:1310 CENTERVIEW DR
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-4349
Practice Address - Country:US
Practice Address - Phone:501-410-1127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-19
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR121512163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse