Provider Demographics
NPI:1144608019
Name:EVANS, BERNARDINE (PT,DPT,GCS)
Entity Type:Individual
Prefix:MRS
First Name:BERNARDINE
Middle Name:
Last Name:EVANS
Suffix:
Gender:F
Credentials:PT,DPT,GCS
Other - Prefix:MISS
Other - First Name:BERNARDINE
Other - Middle Name:
Other - Last Name:SPAULDING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1701 POPLAR LN NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20012-1135
Mailing Address - Country:US
Mailing Address - Phone:202-525-5572
Mailing Address - Fax:
Practice Address - Street 1:2250 HICKORY RD STE 240
Practice Address - Street 2:
Practice Address - City:PLYMOUTH MEETING
Practice Address - State:PA
Practice Address - Zip Code:19462-2225
Practice Address - Country:US
Practice Address - Phone:610-834-1122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-12
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPT8710832251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics