Individual
SANDRA EVELYN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2113A ARCH STREET, PHILADELPHIA, PA 19103
(609) 970-1549
Mailing address
2113A ARCH STREET, PHILADELPHIA, PA 19103
(609) 970-1549
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
RN312151L
PA
Other
Enumeration date
06/30/2022
Last updated
06/30/2022
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