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Individual

CJ DEVON BIRGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
APRN, FNP-C

Contact information

Practice address
5325 US HWY 98 S, LAKELAND, FL 33812
(863) 937-3139
(863) 937-3147
Mailing address
6406 BUTTERNUT DR, LAKELAND, FL 33813-3679

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN11017275
FL
363LF0000X
Family Nurse Practitioner
APRN11017275
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
113059800
FL
Enumeration date
01/05/2022
Last updated
10/16/2025
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