Individual
MR. WILLIAM FRANCIS DEVINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
2187 SWANSON AVE, LAKE HAVASU CITY, AZ 86403-6838
(928) 855-3432
Mailing address
166 CHRISTINA MARIE DR, O FALLON, MO 63368-7872
(314) 443-9228
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2008006146
MO
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
2018025246
MO
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
229481
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
498748
—
AZ
Enumeration date
10/03/2011
Last updated
09/21/2020
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