Provider Demographics
NPI:1326733320
Name:EVANS, ERIN STEPHANIE (RN, CNP)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:STEPHANIE
Last Name:EVANS
Suffix:
Gender:F
Credentials:RN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 MIDDLESEX RD
Mailing Address - Street 2:
Mailing Address - City:STONEHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02180-2819
Mailing Address - Country:US
Mailing Address - Phone:617-895-9628
Mailing Address - Fax:
Practice Address - Street 1:14 MIDDLESEX RD
Practice Address - Street 2:
Practice Address - City:STONEHAM
Practice Address - State:MA
Practice Address - Zip Code:02180-2819
Practice Address - Country:US
Practice Address - Phone:617-895-9628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-06
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2301309363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily