Healthcare Provider Details

I. General information

NPI: 1770745812
Provider Name (Legal Business Name): SUZANNE DEVITO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2008
Last Update Date: 06/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6040 PUBLIC LANDING ROAD WORCESTER COUNTY HEALTH DEPARTMENT
SNOW HILL MD
21801
US

IV. Provider business mailing address

125 HARFORD RD
SALISBURY MD
21801-8061
US

V. Phone/Fax

Practice location:
  • Phone: 410-632-1100
  • Fax: 410-632-0906
Mailing address:
  • Phone: 410-860-9337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberR165967
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: