Provider Demographics
NPI:1053509190
Name:MCDEVITT, AMANDA LYNN
Entity Type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:LYNN
Last Name:MCDEVITT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3406 EDENWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-8213
Mailing Address - Country:US
Mailing Address - Phone:757-639-6473
Mailing Address - Fax:
Practice Address - Street 1:USS THEODORE ROOSEVELT
Practice Address - Street 2:CVN 71
Practice Address - City:FPO
Practice Address - State:AE
Practice Address - Zip Code:09599 2871
Practice Address - Country:US
Practice Address - Phone:757-396-3834
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-12
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman