Individual
DEVIN KENNETH WERNETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3456 E 17TH ST STE 190, AMMON, ID 83406-6749
(208) 524-2222
Mailing address
3456 E 17TH ST STE 190, AMMON, ID 83406-6749
(208) 524-2222
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
IDTPID009778
—
ID
Enumeration date
07/27/2023
Last updated
08/09/2025
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