Healthcare Provider Details

I. General information

NPI: 1013871276
Provider Name (Legal Business Name): SCOTT AR DEVRIES NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

654 RED BUD RD NE
CALHOUN GA
30701-1963
US

IV. Provider business mailing address

654 RED BUD RD NE
CALHOUN GA
30701-1963
US

V. Phone/Fax

Practice location:
  • Phone: 706-466-7076
  • Fax:
Mailing address:
  • Phone: 706-466-7076
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN-NP330662
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: