Provider Demographics
NPI:1487468583
Name:DEVOUS AESTHETIC & HEALTH MAINTENANCE
Entity type:Organization
Organization Name:DEVOUS AESTHETIC & HEALTH MAINTENANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:S
Authorized Official - Last Name:DEVOUS
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:618-599-0342
Mailing Address - Street 1:2530 COUNTY ROAD 375 E
Mailing Address - Street 2:
Mailing Address - City:MILL SHOALS
Mailing Address - State:IL
Mailing Address - Zip Code:62862-2116
Mailing Address - Country:US
Mailing Address - Phone:618-599-0342
Mailing Address - Fax:
Practice Address - Street 1:4907 THEATER DR
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-8541
Practice Address - Country:US
Practice Address - Phone:618-599-0342
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-07
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty