Provider Demographics
NPI:1942253422
Name:GULLETT, DEVIN JAMES (CRNA)
Entity type:Individual
Prefix:MR
First Name:DEVIN
Middle Name:JAMES
Last Name:GULLETT
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 ROSS CLARK CIRCLE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36301-2125
Mailing Address - Country:US
Mailing Address - Phone:850-482-7200
Mailing Address - Fax:
Practice Address - Street 1:2800 ROSS CLARK CIRCLE
Practice Address - Street 2:SUITE 3
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36301-2125
Practice Address - Country:US
Practice Address - Phone:334-793-3411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3078332367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL306142600Medicaid