Individual
DEVON LORAE MORTLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1313 W MCGALLIARD RD, MUNCIE, IN 47303-1774
(765) 287-8460
(765) 287-8920
Mailing address
1313 W MCGALLIARD RD, MUNCIE, IN 47303-1774
(765) 287-8460
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
28233644A
IN
363L00000X
Nurse Practitioner
Primary
71009894A
IN
Other
Enumeration date
12/19/2019
Last updated
03/11/2020
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