Individual
ADDIE GRACE EVERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
240 MEETING HOUSE LN, SOUTHAMPTON, NY 11968-5009
(631) 726-8200
Mailing address
95 WESTMINSTER DR, JAMESTOWN, NY 14701-4438
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
804857-01
NY
Other
Enumeration date
05/04/2026
Last updated
05/04/2026
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