Individual
MS. AMANDA EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1000 ALLIANCE DR, HAZLETON, PA 18202-3234
(570) 459-2226
(570) 459-2511
Mailing address
PO BOX 783311, PHILADELPHIA, PA 19178-3311
(484) 884-4500
(484) 884-0699
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA 056607
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103145630-0001
—
PA
Enumeration date
01/08/2014
Last updated
02/13/2020
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