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General NPI Number Information
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NPI Number | 1972081966
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Entity Type | Individual
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Provider Name | MELISSA ANN DEVLIN PA
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Gender | Female
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Dates
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Enumeration Date | 08/01/2018
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Last Update Date | 09/11/2023
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Provider Practice Location Address
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Address Line | 200 HIGH SERVICE AVE
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City | NORTH PROVIDENCE
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State | RI
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Zip | 02904-5113
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Country | US
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Telephone | 401-456-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 15 PARKSIDE PL APT 220
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City | REVERE
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State | MA
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Zip | 02151-1151
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Country | US
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Telephone | 401-714-9756
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA6657
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License Number State | MA
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