Provider Demographics
NPI:1508730656
Name:GAFFNEY-DEVOUX, KWONA TARIA (APRN)
Entity type:Individual
Prefix:MRS
First Name:KWONA
Middle Name:TARIA
Last Name:GAFFNEY-DEVOUX
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8613 OLD KINGS RD S STE 602
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32217-4863
Mailing Address - Country:US
Mailing Address - Phone:904-493-3390
Mailing Address - Fax:
Practice Address - Street 1:8613 OLD KINGS RD S STE 602
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32217-4863
Practice Address - Country:US
Practice Address - Phone:904-493-3390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-01
Last Update Date:2025-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11040288363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily