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Individual

MRS. THERESA EILEEN DEVEAUX

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
301 HOSPITAL DR, GLEN BURNIE, MD 21061-5803
(410) 553-8300
(410) 553-8349
Mailing address
301 HOSPITAL DRIVE, GLEN BURNIE, MD 21061
(410) 553-8300
(410) 553-8349

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
R093166
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
107423
AMERIGROUP
MD
01
22500900
CIGNA
MD
05
400067600
MD
01
4992
BRAVO/ELDER HEALTH
MD
01
61740701
CAREFIRST BLUE CROSS MD
MD
01
F591 0008
CAREFIRST BLUE CROSS DC
DC
Enumeration date
06/02/2005
Last updated
07/20/2016
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