Provider Demographics
NPI:1073865671
Name:NEVINS, DELPHIS HOPE
Entity Type:Individual
Prefix:
First Name:DELPHIS
Middle Name:HOPE
Last Name:NEVINS
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 1:9042 WALTHAM WOODS RD APT E
Mailing Address - Street 2:
Mailing Address - City:PARKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-2568
Mailing Address - Country:US
Mailing Address - Phone:757-784-2377
Mailing Address - Fax:
Practice Address - Street 1:9042 WALTHAM WOODS RD APT E
Practice Address - Street 2:
Practice Address - City:PARKVILLE
Practice Address - State:MD
Practice Address - Zip Code:21234-2568
Practice Address - Country:US
Practice Address - Phone:757-784-2377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-05
Last Update Date:2012-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA3592225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant