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General NPI Number Information
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NPI Number | 1225747967
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Entity Type | Individual
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Provider Name | YADIRA DEVANEY PMHNP
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Gender | Female
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Dates
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Enumeration Date | 11/22/2022
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Last Update Date | 04/25/2023
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Provider Practice Location Address
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Address Line | 993 45TH ST
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City | MANGONIA PARK
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State | FL
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Zip | 33407-2413
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Country | US
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Telephone | 561-667-0511
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Fax |
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Provider Business Mailing Address
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Address Line | 3294 W MALLORY BLVD
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City | JUPITER
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State | FL
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Zip | 33458-8771
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Country | US
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Telephone | 561-667-0511
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 11023156
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License Number State | FL
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