Individual
LILLIAN REGINA DEVINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
5050 POWDERHOUSE RD, CHEYENNE, WY 82009-4800
(307) 634-1311
(307) 634-1271
Mailing address
5050 POWDERHOUSE RD, CHEYENNE, WY 82009-4800
(307) 634-1311
(307) 634-1271
Taxonomy
Speciality
Code
Description
License number
State
163WG0600X
Gerontology Registered Nurse
46259
WY
363LP2300X
Primary Care Nurse Practitioner
Primary
46259
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
WY
Enumeration date
03/03/2021
Last updated
09/27/2021
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