Provider Demographics
NPI:1043923956
Name:DEVANNY, MIRIAM PATRICIA (RN)
Entity Type:Individual
Prefix:MRS
First Name:MIRIAM
Middle Name:PATRICIA
Last Name:DEVANNY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 W CORK ST
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-3870
Mailing Address - Country:US
Mailing Address - Phone:540-536-5200
Mailing Address - Fax:540-536-3251
Practice Address - Street 1:333 W CORK ST
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-3870
Practice Address - Country:US
Practice Address - Phone:540-536-5200
Practice Address - Fax:540-536-3251
Is Sole Proprietor?:No
Enumeration Date:2023-01-05
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA00001272155163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health