DEVIANNA GUNAWAN-PON NP
NPI 1174477749
Nurse Practitioner - Family in Suwanee, GA
Active since February 23, 2026
About Devianna Gunawan-pon Np NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DEVIANNA GUNAWAN-PON NP (NPI 1174477749) is an individual family provider in Suwanee, Georgia, licensed in Georgia (F02260479) and active in the NPI registry since February 2026.
NPPES Registry Identity
NPI1174477749
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameDEVIANNA GUNAWAN-PONCredential: NP
Location Address1460 DISTRIBUTION DR APT 5106Suwanee, GA 30024-4390
Mailing Address1460 Distribution Dr Apt 5106Suwanee, GA 30024-4390
Phone(850) 490-1138
Sole ProprietorNo
Enumeration DateFebruary 23, 2026
NPPES CertifiedFebruary 22, 2026
✔ NPI 1174477749 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in GA · F02260479
1460 DISTRIBUTION DR APT 5106, Suwanee, GA 30024
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1174477749, enumerated as an "individual" on February 23, 2026.
The provider is located at 1460 DISTRIBUTION DR APT 5106 SUWANEE, GA 30024 and the phone number is (850) 490-1138.
Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.
