Individual
MS. KATHRYN DEVANEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C, PMHNP-BC
Contact information
Practice address
823 HARRISON ST, TWIN FALLS, ID 83301-3925
(208) 736-2177
(208) 736-2113
Mailing address
19159 HIGHWAY 30, BUHL, ID 83316-5018
(208) 320-2259
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP680A
ID
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
NP680-A
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1345621
PTAN
—
05
—
807769000
—
ID
Enumeration date
06/02/2006
Last updated
02/19/2019
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