Individual
MARY ANN DEVOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3202 MCINTOSH CIR, STE 102, JOPLIN, MO 64804-3646
(417) 347-8688
(417) 347-8693
Mailing address
PO BOX 3810, JOPLIN, MO 64803-3810
(417) 347-8688
(417) 347-8693
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
129116
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100023320A
—
OK
05
—
100335980A
—
KS
01
—
118126
ANTHEM
MO
05
—
423962208
—
MO
01
—
500019747
RR MEDICARE
—
Enumeration date
06/25/2006
Last updated
05/14/2015
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