MEDICARE: DR. JANE MCNAB DEVEAU MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	9701316	NC
2	2084P0805X	Geriatric Psychiatry Physician	9701316	NC

General Provider Information

NPI Number	:	1013019488
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JANE MCNAB DEVEAU MD

Provider Business Mailing Address
First Line	:	2632 DAVIS ST
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27608-2030
Country	:	US
Telephone Number	:	919-803-5747
Fax Number	:

Provider Business Practice Location Address
First Line	:	3305 SUNGATE BLVD
Second Line	:	RALEIGH CBOC - VAMC
City	:	RALEIGH
State	:	NC
Zip	:	27610-2871
Country	:	US
Telephone Number	:	919-212-0129
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/05/2006
Last Update Date	:	11/25/2008

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