Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | SP006594D | PA |
NPI | 1013941574 |
---|---|
Provider Name | Mrs. Maureen Brigid Dever |
First Address | Huntingdon Valley, PA 19006-3218 |
Second Address | Philadelphia, PA 19134 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 08/07/2007 |