Provider Demographics
NPI:1831345701
Name:DEVLIN, DIANE MARIE (RN, BSN, MS)
Entity type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:MARIE
Last Name:DEVLIN
Suffix:
Gender:F
Credentials:RN, BSN, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1519 NYE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LYONS
Mailing Address - State:NY
Mailing Address - Zip Code:14489-9133
Mailing Address - Country:US
Mailing Address - Phone:315-946-5749
Mailing Address - Fax:315-946-7114
Practice Address - Street 1:1519 NYE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:LYONS
Practice Address - State:NY
Practice Address - Zip Code:14489-9133
Practice Address - Country:US
Practice Address - Phone:315-946-5749
Practice Address - Fax:315-946-7114
Is Sole Proprietor?:No
Enumeration Date:2008-08-12
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY424134163WC0400X, 163WC1500X, 163WH0200X, 163WI0600X, 163WM0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WI0600XNursing Service ProvidersRegistered NurseInfection Control
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn