Healthcare Provider Details

I. General information

NPI: 1578523403
Provider Name (Legal Business Name): CORINNE KRYSTINE BESSETTE DEVLIN MSN, RN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 10/19/2020
Certification Date: 10/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BROOKE ARMY MEDICAL CENTER 3551 ROGER BROOKE DRIVE
FORT SAM HOUSTON TX
78234-4504
US

IV. Provider business mailing address

BROOKE ARMY MEDICAL CENTER 3551 ROGER BROOKE DR
JBSA FORT SAM HOUSTON TX
78234-4504
US

V. Phone/Fax

Practice location:
  • Phone: 210-808-4224
  • Fax:
Mailing address:
  • Phone: 210-808-4224
  • Fax: 210-466-2911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN090253 NP
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: