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Individual
SUSAN JANE EVITTS
Active
Individual
SUSAN JANE EVITTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN266659L
PA
363L00000X
Nurse Practitioner
Primary
SP026492
PA
363LP0200X
Pediatric Nurse Practitioner
UP006785D
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1031413460002
—
PA
01
—
2M3648
MEDICARE
PA
Enumeration date
09/08/2005
Last updated
03/30/2023
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