Healthcare Provider Details

I. General information

NPI: 1881235653
Provider Name (Legal Business Name): NANCY DEVENS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2019
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3361 KENTUCKY AVE
INDIANAPOLIS IN
46221-2305
US

IV. Provider business mailing address

4402 TATTERSALL DR
PLAINFIELD IN
46168-9444
US

V. Phone/Fax

Practice location:
  • Phone: 317-240-1588
  • Fax: 317-340-1589
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number26015377A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26015377
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: