Individual
FATIMA EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
232 NORTHB 12PLACE, PROSPECTPARK, NJ 07508
(862) 668-8203
Mailing address
232 NORTH B 12PLACE, PROSPECTPARK, NJ 07508
(862) 668-8203
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
321250
NY
Other
Enumeration date
03/02/2015
Last updated
03/02/2015
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