Healthcare Provider Details

I. General information

NPI: 1942134713
Provider Name (Legal Business Name): DEVIN ELIZABETH PARK LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 LINCOLN DR
BILOXI MS
39531-3349
US

IV. Provider business mailing address

304 LINCOLN DR
BILOXI MS
39531-3349
US

V. Phone/Fax

Practice location:
  • Phone: 448-201-8511
  • Fax:
Mailing address:
  • Phone: 448-201-8511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License NumberPN5253939
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: