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Individual
TERESA EVANS
Active
Individual
TERESA EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
23417
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810005623
—
WV
Enumeration date
02/18/2009
Last updated
02/18/2009
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