Provider Demographics
NPI:1972191625
Name:AMEDIO, DEVON MICHELE (CNM)
Entity type:Individual
Prefix:MISS
First Name:DEVON
Middle Name:MICHELE
Last Name:AMEDIO
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 MONTCALM ST
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:NY
Mailing Address - Zip Code:13126-1398
Mailing Address - Country:US
Mailing Address - Phone:315-343-2590
Mailing Address - Fax:315-343-4197
Practice Address - Street 1:42 MONTCALM ST
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:NY
Practice Address - Zip Code:13126-1398
Practice Address - Country:US
Practice Address - Phone:315-343-2590
Practice Address - Fax:315-343-4197
Is Sole Proprietor?:No
Enumeration Date:2021-01-07
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002037367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife