Provider Demographics
NPI:1558322131
Name:DEVLIN, MARIANNE (CRNA)
Entity Type:Individual
Prefix:
First Name:MARIANNE
Middle Name:
Last Name:DEVLIN
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 E FREDERICK ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-2222
Mailing Address - Country:US
Mailing Address - Phone:717-544-5511
Mailing Address - Fax:
Practice Address - Street 1:133 E FREDERICK ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-2222
Practice Address - Country:US
Practice Address - Phone:717-544-5511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN222635L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1137717OtherAETNA-HMO
PA50055755OtherKEYSTONE HEALTH PLAN CENTRAL
PA430034016OtherRR MEDICARE
PA001373902OtherHIGHMARK
PA50055755OtherCAPITAL BLUE CROSS
PA5428730OtherAETNA-NON HMO
PA2066296000OtherINDEPENDENCE BLUE CROSS
PA78787OtherGEISINGER
PA5428730OtherAETNA-NON HMO