Healthcare Provider Details

I. General information

NPI: 1790512200
Provider Name (Legal Business Name): DEVAN RAE CARGNEL DNP, FNP-BC, APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DEVAN CARGNEL DNP, FNP-BC, APRN

II. Dates (important events)

Enumeration Date: 09/18/2024
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1032 POST RD E
WESTPORT CT
06880-5369
US

IV. Provider business mailing address

24 SKYLINE DR
SHELTON CT
06484-2537
US

V. Phone/Fax

Practice location:
  • Phone: 203-635-0770
  • Fax: 203-635-0771
Mailing address:
  • Phone: 203-953-9593
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number2026019510
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number220965
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: