Provider Demographics
NPI:1265015044
Name:EVANS, ERICA (NBC-HWC)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:EVANS
Suffix:
Gender:F
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4137 STONY LN
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18902-1160
Mailing Address - Country:US
Mailing Address - Phone:201-452-2922
Mailing Address - Fax:
Practice Address - Street 1:4137 STONY LN
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18902-1160
Practice Address - Country:US
Practice Address - Phone:201-452-2922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-30
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date: