Provider Demographics
NPI:1871193599
Name:PEARL, EVELYN ANGELA
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:ANGELA
Last Name:PEARL
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 1:113 N 18TH ST
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-7037
Mailing Address - Country:US
Mailing Address - Phone:304-281-0863
Mailing Address - Fax:
Practice Address - Street 1:113 N 18TH ST
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-7037
Practice Address - Country:US
Practice Address - Phone:304-281-0863
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-30
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant