National Provider Identifier Database

DEVA WELLNESS PLLC
Family


Contact Information

DEVA WELLNESS PLLC
1620 W BANNOCK ST
BOISE, ID83702-5156
Phone: 208-918-2242
Fax:
Website:
Specialty Taxonomy Code
* Family 363LF0000X

* Indicates primary specialty

NPI Profile & details for DEVA WELLNESS PLLC

NPI Number 1043055338
Legal business name
LBN
DEVA WELLNESS PLLC
Authorized official TAMRA GERYK - (OWNER, FNP-X)
Entity Organization
Organization subpart No
Enumeration date 06/27/2024
Last updated 06/27/2024 - More than a year ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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