| Devan Walley, | |
|
747 Blunk St, Plymouth, MI 48170-1165 | |
| (734) 620-4230 | |
| Not Available |
| Full Name | Devan Walley |
|---|---|
| Gender | Female |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 747 Blunk St, Plymouth, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417633181 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163W00000X | Registered Nurse | 4704300496 (Michigan) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 4704300496 (Michigan) | Primary |
| Entity Name | Northstar Anesthesia Of Michigan Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1871986372 PECOS PAC ID: 9638481591 Enrollment ID: O20150707000070 |
| Entity Name | Northstar Anesthesia Of Michigan Iii Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1972126209 PECOS PAC ID: 7911325469 Enrollment ID: O20200915001990 |
| Mailing Address | Practice Location Address |
|---|---|
| Devan Walley, 747 Blunk St, Plymouth, MI 48170-1165 Ph: () - | Devan Walley, 747 Blunk St, Plymouth, MI 48170-1165 Ph: (734) 620-4230 |
Kelsey Elise Larios, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 9111 Countrywood Dr, Plymouth, MI 48170 Phone: 734-660-1339 | |
Shawn Sturgis, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 40777 Ann Arbor Rd E, Plymouth, MI 48170 Phone: 800-653-6568 | |
Jessica Lightbody, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 40777 Ann Arbor Rd E, Plymouth, MI 48170 Phone: 800-653-6568 Fax: 313-876-1305 | |
Ryan M. Hook, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 40777 Ann Arbor Rd E, Plymouth, MI 48170 Phone: 734-928-1600 Fax: 734-325-1082 |