Provider Demographics
NPI:1154928398
Name:MUNLEY, DEVON ANNA (CRNP)
Entity type:Individual
Prefix:MISS
First Name:DEVON
Middle Name:ANNA
Last Name:MUNLEY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 PATRICK RD
Mailing Address - Street 2:
Mailing Address - City:PITTSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18640-3246
Mailing Address - Country:US
Mailing Address - Phone:570-815-1124
Mailing Address - Fax:
Practice Address - Street 1:200 S MEADE ST
Practice Address - Street 2:
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18702-6221
Practice Address - Country:US
Practice Address - Phone:570-823-6131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-01
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP022578363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily