Individual
PAMELA EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
206 MOORE RD, QUINCY, FL 32351-7212
(850) 544-7565
Mailing address
206 MOORE RD, QUINCY, FL 32351-7212
(850) 544-7565
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
832443219
TAX ID
FL
Enumeration date
11/07/2018
Last updated
11/07/2018
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