MEDICARE: MS. ALLISON KNOX DEVECHIO NP

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	363LF0000X	Family Nurse Practitioner	201492	NC

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	562014989	OTHER	NC	TRICARE
4	00007	OTHER	NC	BC

General Provider Information

NPI Number	:	1881619252
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ALLISON KNOX DEVECHIO NP

Provider Business Mailing Address
First Line	:	718 CEDAR POINT BLVD
Second Line	:
City	:	CEDAR POINT
State	:	NC
Zip	:	28584-8012
Country	:	US
Telephone Number	:	252-393-6543
Fax Number	:	252-364-3128

Provider Business Practice Location Address
First Line	:	3085 RICHLANDS HWY STE 4
Second Line	:
City	:	JACKSONVILLE
State	:	NC
Zip	:	28540-2977
Country	:	US
Telephone Number	:	910-939-4848
Fax Number	:	910-939-4859

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

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	11/13/2017

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