Provider Demographics
NPI:1477769198
Name:DEINLEIN, EVALYN ELIZABETH (CRNP)
Entity Type:Individual
Prefix:MS
First Name:EVALYN
Middle Name:ELIZABETH
Last Name:DEINLEIN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3753 TIMAHOE CIR
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21236-2965
Mailing Address - Country:US
Mailing Address - Phone:410-396-0176
Mailing Address - Fax:410-396-7897
Practice Address - Street 1:1515 W NORTH AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21217-1735
Practice Address - Country:US
Practice Address - Phone:410-396-0176
Practice Address - Fax:410-396-7897
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDR059732363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health