Provider Demographics
NPI:1073278123
Name:DEVLIN, MAURA
Entity Type:Individual
Prefix:
First Name:MAURA
Middle Name:
Last Name:DEVLIN
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 1:2681 NOBLEWOOD CIR APT 2621
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-1883
Mailing Address - Country:US
Mailing Address - Phone:617-312-0975
Mailing Address - Fax:
Practice Address - Street 1:2681 NOBLEWOOD CIR APT 2621
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27604-1883
Practice Address - Country:US
Practice Address - Phone:617-312-0975
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-03
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC328589163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant