Individual
MARTHA JEAN DEVERNOE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
9102 KINGSTON RD, BRADENTON, FL 34210-2244
(941) 761-2393
(941) 761-2393
Mailing address
9102 KINGSTON RD, BRADENTON, FL 34210-2244
(941) 761-2393
(941) 761-2393
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
RN3311102
FL
Other
Enumeration date
01/28/2007
Last updated
07/09/2007
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