Healthcare Provider Details

I. General information

NPI: 1215895214
Provider Name (Legal Business Name): GEETHU DEVASIA FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2026
Last Update Date: 01/10/2026
Certification Date: 01/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 HAMILL RD STE 272N
BALTIMORE MD
21210-1806
US

IV. Provider business mailing address

4248 CHAPEL GATE PL
BELCAMP MD
21017-1608
US

V. Phone/Fax

Practice location:
  • Phone: 410-670-5500
  • Fax:
Mailing address:
  • Phone: 443-760-8766
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberR213336
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: