Healthcare Provider Details

I. General information

NPI: 1902356074
Provider Name (Legal Business Name): KYLE MCDEVITT DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2016
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3530 S VAL VISTA DR STE 202
GILBERT AZ
85297-7322
US

IV. Provider business mailing address

PO BOX 748817
ATLANTA GA
30374-8817
US

V. Phone/Fax

Practice location:
  • Phone: 480-633-6868
  • Fax: 480-633-6996
Mailing address:
  • Phone: 813-286-0033
  • Fax: 813-282-1806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberF143616
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAP11663
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: