=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558205138
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CATHERINE ANN DEVER FNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/15/2026
-----------------------------------------------------
Last Update Date | 04/15/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2225 HALEY BARBOUR PKWY
-----------------------------------------------------
City | YAZOO CITY
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 39194-4796
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 662-751-4800
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 611 LIVE OAK DR
-----------------------------------------------------
City | MADISON
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 39110-9364
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 662-751-4800
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | F07170847
-----------------------------------------------------
License Number State | MS
-----------------------------------------------------