Provider Demographics
NPI:1194566331
Name:DEVENS, MEAGHAN SUSANNE (FNP)
Entity type:Individual
Prefix:
First Name:MEAGHAN
Middle Name:SUSANNE
Last Name:DEVENS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:860 OMNI BLVD STE 8
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4434
Mailing Address - Country:US
Mailing Address - Phone:757-232-8860
Mailing Address - Fax:757-232-8875
Practice Address - Street 1:1540 BREEZEPORT WAY STE 100
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23435-3752
Practice Address - Country:US
Practice Address - Phone:757-538-7275
Practice Address - Fax:757-335-7230
Is Sole Proprietor?:No
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0001289826363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily