Provider Demographics
NPI:1093881047
Name:GOINS, EVANTHE LUCILLE (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:EVANTHE
Middle Name:LUCILLE
Last Name:GOINS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:285 DAVIDSON AVE
Mailing Address - Street 2:STE 204
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-4153
Mailing Address - Country:US
Mailing Address - Phone:732-271-1400
Mailing Address - Fax:732-271-3544
Practice Address - Street 1:285 DAVIDSON AVE
Practice Address - Street 2:STE 204
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-4153
Practice Address - Country:US
Practice Address - Phone:732-271-1400
Practice Address - Fax:732-271-3544
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR08432600367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ182997M1JMedicare PIN