| Doctor Name: | JESSIC A DEVINE |
| NPI Number: | 1013354430 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | RN46601 |
| Business Practice Address: | 164 Summit Ave Suite C Providence, RI - 029062853 |
| Business Phone Number: | 4017937243 |
| Business Fax Number: | 4017932953 |
| Mailing Address: | 164 Summit Ave, Suite C PROVIDENCE |
| State: | RI |
| Postal Code: | 029062853 |
| Phone Number: | 4017937243 |
| Fax Number: | 4017932953 |
| NPI Enumeration Date: | 05/24/2013 |
| NPI Last Update Date: | 05/24/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP2201X |
| License Number: | RN46601 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | RI |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Ambulatory Care |
| Taxonomy Definition: | |