Provider Demographics
NPI:1912520198
Name:MCDEVITT, KATELYN J (OD)
Entity type:Individual
Prefix:DR
First Name:KATELYN
Middle Name:J
Last Name:MCDEVITT
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:3840 GRAND WAY
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-4788
Mailing Address - Country:US
Mailing Address - Phone:952-848-2020
Mailing Address - Fax:952-922-2015
Practice Address - Street 1:3840 GRAND WAY
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-4788
Practice Address - Country:US
Practice Address - Phone:952-848-2020
Practice Address - Fax:952-922-2015
Is Sole Proprietor?:No
Enumeration Date:2020-05-22
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN3674152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist