Individual provider Active NPI

Devlin Stitt, LPN

  • Licensed Practical Nurse
  • Blaine, MN
National Provider Identifier
1841698743
Registry record updated Dec 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
L034293-3 Issued in MN
Practice address
12259 Jefferson St NE
Blaine, MN 55434-2002
Phone
(612) 870-3787
Fax
(612) 870-3798
NPI assigned
Dec 9, 2014
Last updated
Dec 9, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X L034293-3 MN Primary

Addresses

Primary practice location

12259 Jefferson St NE
Blaine, MN 55434-2002

Mailing address

12259 Jefferson St NE
Blaine, MN 55434-2002
Phone (612) 870-3787

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
L034293-3MNMDLicensed Practical Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1418083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418083200000",
    "number": "1841698743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12259 JEFFERSON ST NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554342002",
            "telephone_number": "612-870-3787",
            "fax_number": "612-870-3798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12259 JEFFERSON ST NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554342002",
            "telephone_number": "612-870-3787",
            "fax_number": "612-870-3798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STITT",
        "first_name": "DEVLIN",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-09",
        "last_updated": "2014-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MN",
            "license": "L034293-3",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blaine, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.