Healthcare Provider Details

I. General information

NPI: 1417508946
Provider Name (Legal Business Name): DEVIN VERONICA PARKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2019
Last Update Date: 06/07/2024
Certification Date: 06/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 CENTENNIAL DR
PEABODY MA
01960-7938
US

IV. Provider business mailing address

70 FARRWOOD AVE APT 7
NORTH ANDOVER MA
01845-4422
US

V. Phone/Fax

Practice location:
  • Phone: 978-535-1110
  • Fax:
Mailing address:
  • Phone: 631-732-5222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number383214
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2322349
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberRN2322349
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: