Provider Demographics
NPI:1164959326
Name:KAMMAN, DEVORAH LEAH (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:DEVORAH
Middle Name:LEAH
Last Name:KAMMAN
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:DEVORAH
Other - Middle Name:LEAH
Other - Last Name:BOGART
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:443 NORTON PKWY
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-2830
Mailing Address - Country:US
Mailing Address - Phone:203-675-5308
Mailing Address - Fax:
Practice Address - Street 1:443 NORTON PKWY
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-2830
Practice Address - Country:US
Practice Address - Phone:203-675-5308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-18
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT129076163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health