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Individual

AMY L DEVORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNM

Contact information

Practice address
2500 PERES AVE, MEMPHIS, TN 38108-1660
(901) 515-5500
(901) 458-5591
Mailing address
877 JEFFERSON AVE, ATTN: PROVIDER ENROLLMENT, MEMPHIS, TN 38103-2807
(901) 545-8336
(901) 545-8122

Taxonomy

Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
8124
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010278317
VA
01
300917
ANTHEM CROSSOVER PN
VA
Enumeration date
08/08/2006
Last updated
08/13/2014
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