Provider Demographics
NPI:1568153112
Name:DEVARENNES, SEAN
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:DEVARENNES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 ARMY NAVY DR APT 701
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22202-2028
Mailing Address - Country:US
Mailing Address - Phone:301-691-8632
Mailing Address - Fax:
Practice Address - Street 1:13950 BRANDYWINE RD STE 200
Practice Address - Street 2:
Practice Address - City:BRANDYWINE
Practice Address - State:MD
Practice Address - Zip Code:20613-5815
Practice Address - Country:US
Practice Address - Phone:301-782-2250
Practice Address - Fax:301-782-2251
Is Sole Proprietor?:No
Enumeration Date:2023-05-16
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program