Provider Demographics
NPI:1174354229
Name:ABBOTT, DEVIN AILI
Entity type:Individual
Prefix:
First Name:DEVIN
Middle Name:AILI
Last Name:ABBOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 THREE OAKS DR
Mailing Address - Street 2:
Mailing Address - City:HARLEM
Mailing Address - State:GA
Mailing Address - Zip Code:30814-4016
Mailing Address - Country:US
Mailing Address - Phone:706-421-7451
Mailing Address - Fax:
Practice Address - Street 1:3000 BAPTIST HEALTH BLVD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-8739
Practice Address - Country:US
Practice Address - Phone:859-422-9600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical