Provider Demographics
NPI:1457927725
Name:EVANS-BURDEN, NYITECKA S (CNA)
Entity Type:Individual
Prefix:MS
First Name:NYITECKA
Middle Name:S
Last Name:EVANS-BURDEN
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10263
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33733-0263
Mailing Address - Country:US
Mailing Address - Phone:727-648-9402
Mailing Address - Fax:
Practice Address - Street 1:899 40TH AVE S
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33705-3863
Practice Address - Country:US
Practice Address - Phone:727-648-9402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-27
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCNA395451376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide