Provider Demographics
NPI:1821543406
Name:DEVLIN-VARIN, SUSAN V (FNP-C)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:V
Last Name:DEVLIN-VARIN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2002
Mailing Address - Street 2:
Mailing Address - City:DANNEMORA
Mailing Address - State:NY
Mailing Address - Zip Code:12929-2002
Mailing Address - Country:US
Mailing Address - Phone:518-492-2511
Mailing Address - Fax:518-492-2503
Practice Address - Street 1:1156 STATE ROUTE 374
Practice Address - Street 2:
Practice Address - City:DANNEMORA
Practice Address - State:NY
Practice Address - Zip Code:12929-2002
Practice Address - Country:US
Practice Address - Phone:518-492-2511
Practice Address - Fax:518-492-2503
Is Sole Proprietor?:No
Enumeration Date:2016-08-24
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF340677363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily