Provider Demographics
NPI:1568554350
Name:DEVLIN, ELLEN (FNP)
Entity type:Individual
Prefix:
First Name:ELLEN
Middle Name:
Last Name:DEVLIN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:ELLEN
Other - Middle Name:
Other - Last Name:DEVLIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP
Mailing Address - Street 1:1 SHEARWOOD PL APT 614
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-6613
Mailing Address - Country:US
Mailing Address - Phone:475-317-4773
Mailing Address - Fax:
Practice Address - Street 1:514 FIRST AVE
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:NY
Practice Address - Zip Code:10803-1107
Practice Address - Country:US
Practice Address - Phone:866-389-2727
Practice Address - Fax:612-659-7101
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY332094363LF0000X
NYF332094-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily