Provider Demographics
NPI:1386923613
Name:PINKERTON, DEVON E
Entity type:Individual
Prefix:MR
First Name:DEVON
Middle Name:E
Last Name:PINKERTON
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 1:122 1ST AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99701-4871
Mailing Address - Country:US
Mailing Address - Phone:907-452-6434
Mailing Address - Fax:907-451-6598
Practice Address - Street 1:122 1ST AVE SUITE 201
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-4803
Practice Address - Country:US
Practice Address - Phone:907-452-6434
Practice Address - Fax:907-451-6598
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-04
Last Update Date:2011-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251B00000XAgenciesCase Management