MEDICARE: DR. VERNON T DEVINE PH.D.

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
1	103TC0700X	Clinical Psychologist	LP0131	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	61-20116	OTHER	MN	UBH
2	1F223DE	OTHER	MN	BCBSMN
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457443582
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VERNON T DEVINE PH.D.

Provider Business Mailing Address
First Line	:	4500 PARK GLEN RD
Second Line	:	SUITE 360
City	:	ST LOUIS PARK
State	:	MN
Zip	:	55416-4871
Country	:	US
Telephone Number	:	952-929-9478
Fax Number	:	952-929-9548

Provider Business Practice Location Address
First Line	:	4500 PARK GLEN RD
Second Line	:	SUITE 360
City	:	ST LOUIS PARK
State	:	MN
Zip	:	55416-4871
Country	:	US
Telephone Number	:	952-929-9478
Fax Number	:	952-929-9548

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/28/2006
Last Update Date	:	07/08/2007

Similar Medicare Providers

1003882150 — DR. KAJAL DASGUPTA M.D.
Practice Location Address:

2101 E JEFFERSON ST , KAISER PERMANENTE MEDICARE ENROLLMENT
ROCKVILLE, MD
20852-4908

Practice Phone: 301-816-2424
Practice Fax:

1881646115 — MS. MELISSA RYAN STRAUSS P.A.
Practice Location Address:

2101 E JEFFERSON ST , KAISER PERMANENTE MEDICARE ENROLLMENT
ROCKVILLE, MD
20852-4908

Practice Phone: 301-816-2424
Practice Fax:

1497832083 — DR. LYSA CHARLES MD
Practice Location Address:

2101 E JEFFERSON ST PPQA MEDICARE COMPLIANCE UNT 6 WEST , KAISER PERMANENTE MID ATLANTIC PERMANENTE MEDICAL GROUP
ROCKVILLE, MD
20852-4908

Practice Phone: 301-816-6660
Practice Fax: 301-816-6308

1447337068 — STEPHANIE GANSCHOW PHARMD
Practice Location Address:

2500 E 52ND ST N , CIGNA MEDICARE SERVICES
SIOUX FALLS, SD
57104-7106

Practice Phone: 605-373-0100
Practice Fax:

1265427629 — RENEE T VONWEISS PHD LP
Practice Location Address:

4500 PARK GLEN RD , SUITE 450
ST LOUIS PARK, MN
55416-4871

Practice Phone: 952-444-9744
Practice Fax: 952-444-9745

1558383794 — BRIAN EDWARD POWERS II PHD
Practice Location Address:

4500 PARK GLEN RD , SUITE 155
ST LOUIS PARK, MN
55416-4871

Practice Phone: 612-986-4397
Practice Fax: 952-495-1409

Directions to “ DR. VERNON T DEVINE PH.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.