Individual
COLLEEN ANN MCEVOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
150 PIONEER LN, BISHOP, CA 93514-2556
(760) 873-2849
Mailing address
PO BOX 22210, OAKLAND, CA 94623-2210
(510) 535-4000
(510) 535-4189
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
NP16714
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FHC70543G
—
CA
Enumeration date
04/10/2007
Last updated
05/01/2015
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