Deveraux, Katelyn Miranda

Deveraux, Katelyn Miranda is an individual health care provider with primary practice located at 902 Lakeview Ave , Pueblo CO 81004-3597. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / General Practice, Student, Health Care / Student in an Organized Health Care Education/Training Program. Student, Health Care / Student in an Organized Health Care Education/Training Program is her primary health care specialty. Deveraux, Katelyn Miranda can be contacted via phone (719) 557-5855.

Contact Information

Primary practice address
902 Lakeview Ave Pueblo CO 81004-3597
Phone: (719) 557-5855
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X TL.0008870 Colorado
Allopathic & Osteopathic Physicians / General Practice 208D00000X DR.0069707 Colorado
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X TL.0008870 Colorado

Profile Details

NPI number 1386225522
LBN Legal business name Deveraux, Katelyn Miranda
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 19th, 2021
Last updated Apr 17th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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