MEDICARE: GEETHU DEVASIA FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	R213336	MD

General Provider Information

NPI Number	:	1215895214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEETHU DEVASIA FNP-C

Provider Business Mailing Address
First Line	:	2 HAMILL RD STE 272N
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21210-1806
Country	:	US
Telephone Number	:	410-670-5500
Fax Number	:

Provider Business Practice Location Address
First Line	:	2 HAMILL RD STE 272N
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21210-1806
Country	:	US
Telephone Number	:	410-670-5500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/10/2026
Last Update Date	:	03/03/2026

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Directions to “ GEETHU DEVASIA FNP-C” Practice Location

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