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Individual

JUDITH ELAINE DEVITA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
21 W CLARKE AVE, MILFORD, DE 19963-1840
(302) 422-4047
Mailing address
PO BOX 284, MILFORD, DE 19963-0284

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
6 OA00005
DE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
L10009833
LICENSE
DE
Enumeration date
08/05/2006
Last updated
07/08/2007
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