Provider Demographics
NPI:1871502005
Name:MORALES, EVELYN R (NP)
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:R
Last Name:MORALES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 MONTEVALLO DR
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-2322
Mailing Address - Country:US
Mailing Address - Phone:404-256-6535
Mailing Address - Fax:
Practice Address - Street 1:2675 N DECATUR RD STE 301
Practice Address - Street 2:SUITE 301
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-6132
Practice Address - Country:US
Practice Address - Phone:404-294-0473
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN087831363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health