Individual
ELIZABETH A EVERGREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
930 S SALINA ST, SYRACUSE, NY 13202-3530
(315) 435-6266
(315) 234-0465
Mailing address
6846 BUCKLEY RD, NORTH SYRACUSE, NY 13212-4275
(315) 410-6400
(315) 410-6410
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
345954
NY
364SF0001X
Family Health Clinical Nurse Specialist
34594
NY
Other
Enumeration date
06/22/2020
Last updated
11/12/2024
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