Provider Demographics
NPI:1215473848
Name:WELLING, DEVON CAROLINE (CNM)
Entity type:Individual
Prefix:MRS
First Name:DEVON
Middle Name:CAROLINE
Last Name:WELLING
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:MISS
Other - First Name:DEVON
Other - Middle Name:CAROLINE
Other - Last Name:NEUMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:31000 COUNTRY BLUFF
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48331
Mailing Address - Country:US
Mailing Address - Phone:810-247-1178
Mailing Address - Fax:
Practice Address - Street 1:31000 COUNTRY BLUFF
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48331
Practice Address - Country:US
Practice Address - Phone:810-247-1178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-06
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704284668367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife