Provider Demographics
NPI:1598049439
Name:MCDEVITT, NANCY (STNA)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:
Last Name:MCDEVITT
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4055 SOUTH AVE
Mailing Address - Street 2:LOT 125
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-1360
Mailing Address - Country:US
Mailing Address - Phone:330-314-4588
Mailing Address - Fax:
Practice Address - Street 1:4055 SOUTH AVE LOT 125
Practice Address - Street 2:
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-1345
Practice Address - Country:US
Practice Address - Phone:330-314-4588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-10
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH400629390607376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide