Provider Demographics
NPI:1194536458
Name:WOOTEN, DEVIN MARKISON (FNP)
Entity type:Individual
Prefix:
First Name:DEVIN
Middle Name:MARKISON
Last Name:WOOTEN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 SALEM ST
Mailing Address - Street 2:
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-3013
Mailing Address - Country:US
Mailing Address - Phone:609-218-9148
Mailing Address - Fax:
Practice Address - Street 1:180 SALEM ST
Practice Address - Street 2:
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-3013
Practice Address - Country:US
Practice Address - Phone:609-218-9148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-16
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2360418163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse