Individual
DEVRI BURNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
167 E 1ST S, RIGBY, ID 83442-1401
(208) 745-8747
Mailing address
167 E 1ST S, RIGBY, ID 83442-1401
(208) 745-8747
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
08/01/2022
Last updated
09/13/2023
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