Individual
EVELYN LAKE-HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
238 SUMMAR DR, JACKSON, TN 38301-3906
(731) 541-8200
(731) 935-8327
Mailing address
PO BOX 10414, C O PARADIGM HEALTH, LARGO, FL 33773-0414
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APN6691
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3901225
—
TN
01
—
4099612
BCBS W PARADIGM 80
TN
01
—
P00211926
RR MCARE W PARADIGM 80
TN
Enumeration date
03/27/2007
Last updated
01/15/2018
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