Individual
MRS. SUE LILLIAN DEVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3449 E REZANOF DR, KODIAK, AK 99615
(907) 486-9870
(907) 486-9897
Mailing address
3449 E REZANOF DR, KODIAK, AK 99615
(907) 486-9870
(907) 486-9897
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4497
AK
208D00000X
General Practice Physician
Primary
4497
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CL3225
—
AK
Enumeration date
02/25/2010
Last updated
02/25/2010
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