Individual
KIM G DEVOU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2301 N MLK BLVD, CLOVIS, NM 88101-9401
(575) 762-4455
(575) 935-5455
Mailing address
2301 N DR MARTIN LUTHER KING JR BLVD, CLOVIS, NM 88101-9401
(575) 762-4455
(575) 935-5455
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
CNP-01670
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39778088
—
NM
Enumeration date
09/16/2010
Last updated
12/15/2016
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