Individual
CHARISSA EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
29 E ONEIDA ST, BALDWINSVILLE, NY 13027-2400
(315) 638-6123
Mailing address
622 SWAMP RD, BALDWINSVILLE, NY 13027-9617
(315) 414-6748
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
770729
NY
Other
Enumeration date
03/22/2024
Last updated
01/06/2026
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