Provider Demographics
NPI:1336684000
Name:EVANOWSKI, ARLENE (RN)
Entity Type:Individual
Prefix:
First Name:ARLENE
Middle Name:
Last Name:EVANOWSKI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 BIRCH TRL
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:NY
Mailing Address - Zip Code:10512-5727
Mailing Address - Country:US
Mailing Address - Phone:845-225-4430
Mailing Address - Fax:
Practice Address - Street 1:41 BIRCH TRL
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512-5727
Practice Address - Country:US
Practice Address - Phone:845-225-4430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-04
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY231211163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse