Provider Demographics
NPI:1083350821
Name:DEVKOTA, SHRAVAN KUMAR (FNP-C)
Entity type:Individual
Prefix:
First Name:SHRAVAN
Middle Name:KUMAR
Last Name:DEVKOTA
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 S TYLER ST
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79101-2313
Mailing Address - Country:US
Mailing Address - Phone:806-651-8200
Mailing Address - Fax:
Practice Address - Street 1:720 S TYLER ST
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79101-2313
Practice Address - Country:US
Practice Address - Phone:806-651-8200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-05
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1069125363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily