Basic Information
| Provider Information | |||||||||
| NPI: | 1578077848 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NYE | ||||||||
| FirstName: | DEVON | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 329 BLUEBONNET CIR | ||||||||
| Address2: | |||||||||
| City: | MC GREGOR | ||||||||
| State: | TX | ||||||||
| PostalCode: | 766579510 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2547177626 | ||||||||
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| Practice Location | |||||||||
| Address1: | 120 HILLCREST MEDICAL BLVD STE 200 | ||||||||
| Address2: | |||||||||
| City: | WACO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 767128950 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2542970400 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/25/2017 | ||||||||
| LastUpdateDate: | 02/10/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/10/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0200X | 803417 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics |
No ID Information.