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NPI Code Detail

MEDICARE: MRS. JUDITH ANN DEVLIN RN, AOCNP

MEDICARE: MRS. JUDITH ANN DEVLIN RN, AOCNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2200XAdult Health Nurse Practitioner515447UT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1154376101OTHERTXTPI

General Provider Information

NPI Number : 1578729661
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JUDITH ANN DEVLIN RN, AOCNP
Provider Business Mailing Address
First Line : 5323 HARRY HINES BLVD
Second Line : MAIL CODE 8852
City : DALLAS
State : TX
Zip : 75390-7201
Country : US
Telephone Number : 214-648-4180
Fax Number : 214-648-1955
Provider Business Practice Location Address
First Line : 5323 HARRY HINES BLVD
Second Line : MAIL CODE 8852
City : DALLAS
State : TX
Zip : 75390-7201
Country : US
Telephone Number : 214-648-4180
Fax Number : 214-648-1955
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2008
Last Update Date : 07/29/2008

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