Provider Demographics
NPI:1518220458
Name:HARWELL, EVELYN LEWIS (RN)
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:LEWIS
Last Name:HARWELL
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 1:353 N 12TH ST
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70802-4612
Mailing Address - Country:US
Mailing Address - Phone:225-242-4862
Mailing Address - Fax:225-342-5193
Practice Address - Street 1:353 N 12TH ST
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70802-4612
Practice Address - Country:US
Practice Address - Phone:225-242-4862
Practice Address - Fax:225-342-5193
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-15
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN098692163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health