Healthcare Provider Details

I. General information

NPI: 1821907098
Provider Name (Legal Business Name): DEVON SPINKS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 90561
MILWAUKEE WI
53209-0561
US

IV. Provider business mailing address

PO BOX 90561
MILWAUKEE WI
53209-0561
US

V. Phone/Fax

Practice location:
  • Phone: 414-708-2501
  • Fax:
Mailing address:
  • Phone: 414-510-7306
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License NumberS1521779638006
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: