Individual
MICHAEL J EVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
56 N MOUNTAIN BLVD, MOUNTAIN TOP, PA 18707-1117
(570) 474-1130
(570) 474-1174
Mailing address
56 N MOUNTAIN BLVD, MOUNTAIN TOP, PA 18707-1117
(570) 474-1130
(570) 474-1174
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN503170L
PA
Other
Enumeration date
08/11/2005
Last updated
12/24/2009
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