Provider Demographics
NPI:1003881475
Name:DELORI, EVELYNE L (RNCS MSN)
Entity Type:Individual
Prefix:
First Name:EVELYNE
Middle Name:L
Last Name:DELORI
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Gender:F
Credentials:RNCS MSN
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Mailing Address - Street 1:585 597 MERRIMACK STREET
Mailing Address - Street 2:LOWELL COMMUNITY HEALTH CENTER
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01854
Mailing Address - Country:US
Mailing Address - Phone:978-746-7778
Mailing Address - Fax:978-970-0359
Practice Address - Street 1:585 597 MERRIMACK STREET
Practice Address - Street 2:LOWELL COMMUNITY HEALTH CENTER
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01854
Practice Address - Country:US
Practice Address - Phone:978-746-7778
Practice Address - Fax:978-970-0359
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2008-11-19
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Provider Licenses
StateLicense IDTaxonomies
MA228032363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANP346601OtherMEDICARE PTAN
P40855Medicare UPIN
MANP 3466Medicare ID - Type Unspecified