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NPI Code Detail

MEDICARE: DR. N DEVONNA A'BELLE PA-C, DMSC

MEDICARE: DR. N DEVONNA A'BELLE PA-C, DMSC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant
2363AM0700XMedical Physician Assistant
3363AM0700XMedical Physician AssistantPA 464OK
4363AM0700XMedical Physician Assistant464OK

General Provider Information

NPI Number : 1417051921
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. N DEVONNA A'BELLE PA-C, DMSC
Provider Business Mailing Address
First Line : 18555 S PARK PL
Second Line :
City : INOLA
State : OK
Zip : 74036-3033
Country : US
Telephone Number : 918-693-6601
Fax Number :
Provider Business Practice Location Address
First Line : 4705 S 129TH EAST AVE
Second Line :
City : TULSA
State : OK
Zip : 74134-7005
Country : US
Telephone Number : 918-727-2790
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2006
Last Update Date : 03/03/2021

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