Provider Demographics
NPI:1396899092
Name:DEVINE, CAROL ANN (ARNP)
Entity type:Individual
Prefix:MRS
First Name:CAROL ANN
Middle Name:
Last Name:DEVINE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:473 WOODSIDE DR
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33415-2540
Mailing Address - Country:US
Mailing Address - Phone:561-704-8904
Mailing Address - Fax:
Practice Address - Street 1:826 EVERNIA ST
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-5708
Practice Address - Country:US
Practice Address - Phone:561-355-3159
Practice Address - Fax:561-355-3195
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 306542363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner