Individual
EVERLIN E FERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN,BSN
Contact information
Practice address
25 DONNELLY FARM RD # 1, WALDEN, NY 12586-2270
(646) 836-3046
Mailing address
25 DONNELLY FARM RD # 1, WALDEN, NY 12586-2270
(646) 836-3046
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
763995
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
11027106
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
405170
NY
Other
Enumeration date
11/16/2022
Last updated
07/14/2023
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