Provider Demographics
NPI:1386019610
Name:FLESHER, EVANGELINE M (RN)
Entity Type:Individual
Prefix:
First Name:EVANGELINE
Middle Name:M
Last Name:FLESHER
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 1:6277 S FM 1743
Mailing Address - Street 2:
Mailing Address - City:WINDOM
Mailing Address - State:TX
Mailing Address - Zip Code:75492-4827
Mailing Address - Country:US
Mailing Address - Phone:614-517-0916
Mailing Address - Fax:
Practice Address - Street 1:865 DESHONG DR
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-9313
Practice Address - Country:US
Practice Address - Phone:903-737-1165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-12
Last Update Date:2015-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH388500163W00000X
TX836594163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency
No163W00000XNursing Service ProvidersRegistered Nurse