MEDICARE: DEVIN LYNN PEERY ARNP

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	363L00000X	Nurse Practitioner	R64970	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295717866
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEVIN LYNN PEERY ARNP

Provider Business Mailing Address
First Line	:	1011 14TH AVE NW
Second Line	:
City	:	ARDMORE
State	:	OK
Zip	:	73401-1828
Country	:	US
Telephone Number	:	580-220-6658
Fax Number	:	580-220-6673

Provider Business Practice Location Address
First Line	:	1011 14TH AVE NW
Second Line	:
City	:	ARDMORE
State	:	OK
Zip	:	73401-1828
Country	:	US
Telephone Number	:	580-220-6658
Fax Number	:	580-220-6673

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

Provider Enumeration Date	:	11/18/2005
Last Update Date	:	08/13/2014

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Directions to “ DEVIN LYNN PEERY ARNP” Practice Location

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