Individual
JENNY A EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
360 MERRIMACK ST, LAWRENCE, MA 01843-1740
(978) 557-8800
(978) 557-8633
Mailing address
500 MERRIMACK ST, LAWRENCE, MA 01843-1756
(978) 557-8900
(978) 557-8633
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1857
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30334648
—
NH
05
—
432389499
—
ME
01
—
P00791691
RAILROAD MEDICARE
NH
Enumeration date
10/04/2006
Last updated
07/21/2022
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