Provider Demographics
NPI:1053469106
Name:DEVITA, COLLEEN JANE (RN BSN CNOR CRNFA)
Entity Type:Individual
Prefix:MRS
First Name:COLLEEN
Middle Name:JANE
Last Name:DEVITA
Suffix:
Gender:F
Credentials:RN BSN CNOR CRNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 HOOK MOUNTAIN DR
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:08801-2000
Mailing Address - Country:US
Mailing Address - Phone:908-797-8011
Mailing Address - Fax:908-638-4835
Practice Address - Street 1:100 MADISON AVE
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-6136
Practice Address - Country:US
Practice Address - Phone:973-971-5532
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO06769800163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant