Provider Demographics
NPI:1225455603
Name:AGYEMAN, EVELYN MICHELLE (CRNA)
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:MICHELLE
Last Name:AGYEMAN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5146 MICHAEL ANTHONY LN
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45247-7944
Mailing Address - Country:US
Mailing Address - Phone:859-760-8462
Mailing Address - Fax:
Practice Address - Street 1:3300 MERCY HEALTH BLVD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45211-1103
Practice Address - Country:US
Practice Address - Phone:513-215-1488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-24
Last Update Date:2019-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.15870-NA367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered