Provider Demographics
NPI:1932460243
Name:DUNN- EVANS, SYLVIA LOTTWELL
Entity Type:Individual
Prefix:MS
First Name:SYLVIA
Middle Name:LOTTWELL
Last Name:DUNN- EVANS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:SYLVIA
Other - Middle Name:LOTTWELL
Other - Last Name:DUNN-EVANS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:50 CONNECTICUT ST
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48203-3553
Mailing Address - Country:US
Mailing Address - Phone:313-961-3485
Mailing Address - Fax:
Practice Address - Street 1:2051 W GRAND BLVD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48208-1105
Practice Address - Country:US
Practice Address - Phone:313-961-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-04
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI47042777327163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse