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Individual

DEVOLIA WILSON-JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
525 SHERBURNE AVE, SAINT PAUL, MN 55103-1946
(702) 277-9361
Mailing address
1241 APPALOOSA HILLS AVE, NORTH LAS VEGAS, NV 89081-3323
(702) 466-0463

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1405013329
NV
Enumeration date
01/26/2015
Last updated
08/19/2020
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