Provider Demographics
NPI:1942611553
Name:PEARSON, DEVANNI LYNNE (DC)
Entity type:Individual
Prefix:DR
First Name:DEVANNI
Middle Name:LYNNE
Last Name:PEARSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:DEVANNI
Other - Middle Name:LYNNE
Other - Last Name:PARTRIDGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:1310 BURDICK EXPY E
Mailing Address - Street 2:SUITE A
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58701-4912
Mailing Address - Country:US
Mailing Address - Phone:701-852-5230
Mailing Address - Fax:701-540-0232
Practice Address - Street 1:1310 BURDICK EXPY E
Practice Address - Street 2:SUITE A
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701-4912
Practice Address - Country:US
Practice Address - Phone:701-852-5230
Practice Address - Fax:701-540-0232
Is Sole Proprietor?:No
Enumeration Date:2014-05-16
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND969111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor