Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PP0204X | Pediatric Emergency Physician | C1-0010893 | DE |
N | 208000000X | Pediatrician | A109709 | CA |
Y | 208000000X | Pediatrician | C10010893 | DE |
NPI | 1033440102 |
---|---|
Provider Name | Monique A Devens |
First Address | Rockland, DE 19723-0191 |
Second Address | Wilmington, DE 19803-3607 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/01/2010 |
Last Update Date | 09/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A109709 | CA MEDICAL LISCENSE (01) | CA |
MD60287525 | WA MEDICAL LICENSE (01) | WA |