Provider Demographics
NPI:1689869075
Name:EVANKOVICH, NICOLE KRISTINE (PA)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:KRISTINE
Last Name:EVANKOVICH
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Gender:F
Credentials:PA
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Mailing Address - Street 1:3380 BOULEVARD OF THE ALLIES
Mailing Address - Street 2:SUITE 158
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-3125
Mailing Address - Country:US
Mailing Address - Phone:412-648-8736
Mailing Address - Fax:412-864-1733
Practice Address - Street 1:3380 BOULEVARD OF THE ALLIES
Practice Address - Street 2:SUITE 158
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-3125
Practice Address - Country:US
Practice Address - Phone:412-648-8736
Practice Address - Fax:412-864-1733
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-10
Last Update Date:2017-03-28
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical