Provider Demographics
NPI:1609833581
Name:EVANS, DEBRA JANE (CRNP)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:JANE
Last Name:EVANS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MS
Other - First Name:DEBRA
Other - Middle Name:CALLAHAN
Other - Last Name:EVANS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CRNP
Mailing Address - Street 1:PO BOX 371062
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15251-1357
Mailing Address - Country:US
Mailing Address - Phone:412-432-7276
Mailing Address - Fax:724-432-7265
Practice Address - Street 1:2200 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:FARRELL
Practice Address - State:PA
Practice Address - Zip Code:16121-1357
Practice Address - Country:US
Practice Address - Phone:724-983-8868
Practice Address - Fax:724-983-5250
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAUP005227C363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2082580Medicaid
OH2082580Medicaid
PA021943H6TMedicare PIN
S51115Medicare UPIN
OH2082580Medicaid
PA021943H6TMedicare ID - Type Unspecified
OHNP01981Medicare ID - Type Unspecified