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Individual

HANNAH WALDRIP DEVAZIER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AGPCNP-C

Contact information

Practice address
107 EUREKA ST, BATESVILLE, MS 38606-2533
(662) 563-6000
(662) 563-2200
Mailing address
107 EUREKA ST, BATESVILLE, MS 38606-2533
(662) 563-6000
(662) 563-2200

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
904010
MS
363LA2200X
Adult Health Nurse Practitioner
Primary
904174
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
NONE
NONE
Enumeration date
01/12/2019
Last updated
01/15/2021
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