Provider Demographics
NPI:1265455372
Name:MAY, EVELYN B (FNP)
Entity Type:Individual
Prefix:MRS
First Name:EVELYN
Middle Name:B
Last Name:MAY
Suffix:
Gender:F
Credentials:FNP
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 5127
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98206-5127
Mailing Address - Country:US
Mailing Address - Phone:360-563-8600
Mailing Address - Fax:360-568-0103
Practice Address - Street 1:401 2ND ST
Practice Address - Street 2:
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98290
Practice Address - Country:US
Practice Address - Phone:360-563-8600
Practice Address - Fax:360-568-0103
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2019-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1189363L00000X
SCAPNF1189363LF0000X
OR201801215NP-PP363LF0000X
WAAP60834499363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP1958Medicaid
SCNP1958Medicaid