Provider Demographics
NPI:1760668743
Name:TAPPAN, DEVIN PATRICK
Entity type:Individual
Prefix:MR
First Name:DEVIN
Middle Name:PATRICK
Last Name:TAPPAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1825 GLEN DALE DR
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80215-3017
Mailing Address - Country:US
Mailing Address - Phone:720-621-6525
Mailing Address - Fax:
Practice Address - Street 1:1425 MONROE ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-2708
Practice Address - Country:US
Practice Address - Phone:303-377-2586
Practice Address - Fax:303-329-8759
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-21
Last Update Date:2008-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker