Provider Demographics
NPI:1790512200
Name:CARGNEL, DEVAN RAE (MSN, RN)
Entity type:Individual
Prefix:
First Name:DEVAN
Middle Name:RAE
Last Name:CARGNEL
Suffix:
Gender:F
Credentials:MSN, RN
Other - Prefix:
Other - First Name:DEVAN
Other - Middle Name:
Other - Last Name:CARGNEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSN, RN
Mailing Address - Street 1:24 SKYLINE DR
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484-2537
Mailing Address - Country:US
Mailing Address - Phone:203-953-9593
Mailing Address - Fax:
Practice Address - Street 1:24 SKYLINE DR
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-2537
Practice Address - Country:US
Practice Address - Phone:203-953-9593
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-18
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT220965163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse