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General NPI Number Information
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NPI Number | 1588274997
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Entity Type | Individual
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Provider Name | RACHEL LYNN DEVINE FNP
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Gender | Female
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Dates
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Enumeration Date | 08/01/2020
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Last Update Date | 08/01/2020
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Provider Practice Location Address
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Address Line | 3101 SHIPPERS RD STE 202
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City | VESTAL
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State | NY
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Zip | 13850-2082
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Country | US
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Telephone | 607-754-5342
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Fax |
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Provider Business Mailing Address
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Address Line | 3137 WEBB RD
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City | BINGHAMTON
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State | NY
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Zip | 13903-5527
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Country | US
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Telephone | 607-206-2200
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 346275
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License Number State | NY
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