Healthcare Provider Details

I. General information

NPI: 1255707352
Provider Name (Legal Business Name): DEVYN R THURBER PNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2015
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 E 15TH ST
DOUGLAS AZ
85607-1631
US

IV. Provider business mailing address

4655 N COMMERCE DR
SIERRA VISTA AZ
85635-2497
US

V. Phone/Fax

Practice location:
  • Phone: 520-459-3012
  • Fax:
Mailing address:
  • Phone: 520-459-3012
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAP8041
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: