Provider Demographics
NPI:1134647688
Name:MAJACHANI, EVELYN RUDO (PMHNP)
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:RUDO
Last Name:MAJACHANI
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2723
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27802-2723
Mailing Address - Country:US
Mailing Address - Phone:252-212-3486
Mailing Address - Fax:252-212-3497
Practice Address - Street 1:111 S FAIRVIEW RD
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27801-6971
Practice Address - Country:US
Practice Address - Phone:252-446-3333
Practice Address - Fax:252-446-0426
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-05
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC311120163W00000X
NC5010039363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily