Provider Demographics
NPI:1255459129
Name:DESSER, EVELYN MARCIA (RN, MN, FNP-BC)
Entity type:Individual
Prefix:
First Name:EVELYN
Middle Name:MARCIA
Last Name:DESSER
Suffix:
Gender:F
Credentials:RN, MN, FNP-BC
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Mailing Address - Street 1:5412 JANISANN AVE
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-5307
Mailing Address - Country:US
Mailing Address - Phone:310-621-1104
Mailing Address - Fax:310-398-3611
Practice Address - Street 1:593 W 6TH ST
Practice Address - Street 2:
Practice Address - City:SAN PEDRO
Practice Address - State:CA
Practice Address - Zip Code:90731-2521
Practice Address - Country:US
Practice Address - Phone:310-547-0202
Practice Address - Fax:310-547-5096
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2024-11-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CARN347980363LF0000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care