Provider Demographics
NPI:1639898802
Name:PIERRE, EVENEL (PA)
Entity Type:Individual
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First Name:EVENEL
Middle Name:
Last Name:PIERRE
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Gender:M
Credentials:PA
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Mailing Address - Street 1:856 J CLYDE MORRIS BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23601-1318
Mailing Address - Country:US
Mailing Address - Phone:757-316-5800
Mailing Address - Fax:757-534-5190
Practice Address - Street 1:895 CITY CENTER BLVD STE 152
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-3080
Practice Address - Country:US
Practice Address - Phone:757-599-5505
Practice Address - Fax:757-599-3618
Is Sole Proprietor?:No
Enumeration Date:2022-08-23
Last Update Date:2022-08-23
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Provider Licenses
StateLicense IDTaxonomies
VA0110008789363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant