Individual
MS. DEVON E FENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
750 LAKEVIEW AVE, PORT HURON, MI 48060-2104
(810) 488-5795
Mailing address
4100 CAMPUS RIDGE DR, MIDLAND, MI 48640-6139
(810) 488-5795
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
MI
Other
Enumeration date
05/20/2019
Last updated
05/09/2024
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