Organization
CANCER CARE FOR WOMEN PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACQUELINE EVANS DO (PRESIDENT)
(717) 544-3190
Entity
Organization
Contact information
Practice address
694 GOOD DRIVE, SUITE 205, LANCASTER, PA 17604
(717) 544-3190
(717) 544-3189
Mailing address
694 GOOD DRIVE, SUITE 205, LANCASTER, PA 17604
(717) 544-3190
(717) 544-3189
Taxonomy
Speciality
Code
Description
License number
State
207VX0201X
Gynecologic Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019140550002
—
PA
01
—
021831Q42
MEDICARE PTAN
PA
Enumeration date
07/18/2006
Last updated
03/10/2016
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