Individual
LISA B DEVENPORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
180 W ESPLANADE AVE, KENNER, LA 70065-2467
(800) 893-9698
Mailing address
24 MONTE CARLO DR, KENNER, LA 70065-2029
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
023065
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1490911
—
LA
Enumeration date
06/01/2006
Last updated
03/26/2015
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