Provider Demographics
NPI:1326216508
Name:BEAL, DEVON E (NP, CNS)
Entity Type:Individual
Prefix:
First Name:DEVON
Middle Name:E
Last Name:BEAL
Suffix:
Gender:F
Credentials:NP, CNS
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:34 ANTHONY RD
Mailing Address - Street 2:
Mailing Address - City:HOPEDALE
Mailing Address - State:MA
Mailing Address - Zip Code:01747-2023
Mailing Address - Country:US
Mailing Address - Phone:781-424-0782
Mailing Address - Fax:
Practice Address - Street 1:251 CAUSEWAY ST
Practice Address - Street 2:BOSTON VA
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114
Practice Address - Country:US
Practice Address - Phone:617-248-1035
Practice Address - Fax:172-481-0146
Is Sole Proprietor?:No
Enumeration Date:2008-02-11
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT78195163W00000X
CA729507163W00000X
MARN278807163W00000X, 363LP0808X
CT003728363LP0808X, 364SP0808X
CA18261363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health