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General NPI Number Information
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NPI Number | 1760992911
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Entity Type | Individual
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Provider Name | LORRAINE IRENE DEVRIES RN
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Gender | Female
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Dates
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Enumeration Date | 10/02/2017
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Last Update Date | 10/02/2017
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Provider Practice Location Address
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Address Line | 1316 INDUSTRIAL ACESS DRIVE
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City | TRUMANN
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State | AR
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Zip | 72472
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Country | US
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Telephone | 870-483-6621
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Fax | 872-483-1522
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Provider Business Mailing Address
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Address Line | 1316 INDUSTRIAL PARK DR
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City | TRUMANN
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State | AR
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Zip | 72472-9702
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Country | US
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Telephone | 870-483-6621
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Fax | 872-483-1522
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number | 311
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License Number State | AR
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