Provider Demographics
NPI:1518343524
Name:EVBUOMWAN, FLORENCE
Entity Type:Individual
Prefix:
First Name:FLORENCE
Middle Name:
Last Name:EVBUOMWAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 WARBURTON AVENUE
Mailing Address - Street 2:APT.16L
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701
Mailing Address - Country:US
Mailing Address - Phone:347-223-8012
Mailing Address - Fax:
Practice Address - Street 1:160 WARBURTON AVENUE APT 16L
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701
Practice Address - Country:US
Practice Address - Phone:914-751-1988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-03
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY322397164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse