Provider Demographics
NPI:1245941954
Name:EVANS, EMINE (APN)
Entity type:Individual
Prefix:
First Name:EMINE
Middle Name:
Last Name:EVANS
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:498 S RIVER ST
Mailing Address - Street 2:
Mailing Address - City:WILKES BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18702-3724
Mailing Address - Country:US
Mailing Address - Phone:201-282-8202
Mailing Address - Fax:
Practice Address - Street 1:528 SEVEN BRIDGE RD UNIT 132
Practice Address - Street 2:
Practice Address - City:EAST STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18301-7618
Practice Address - Country:US
Practice Address - Phone:570-218-7476
Practice Address - Fax:806-304-1152
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-13
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01400300363LA2100X
PASP031781363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care