Individual
COURTNEY MANION EVANGELISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2555 COURT DR, SUITE 300, GASTONIA, NC 28054-2134
(704) 868-3256
(704) 868-5870
Mailing address
PO BOX 744786, ATLANTA, GA 30374-4786
(704) 834-2450
(704) 671-5331
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-06539
NC
Other
Enumeration date
08/15/2016
Last updated
12/03/2024
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