Provider Demographics
NPI:1780283432
Name:MCEVOY, MALINDA HELEN (NP)
Entity type:Individual
Prefix:
First Name:MALINDA
Middle Name:HELEN
Last Name:MCEVOY
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 1:244 HIGH WATCH RD
Mailing Address - Street 2:
Mailing Address - City:EFFINGHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03882-8336
Mailing Address - Country:US
Mailing Address - Phone:603-539-8780
Mailing Address - Fax:603-539-8732
Practice Address - Street 1:GREEN MOUNTAIN TREATMENT CENTER
Practice Address - Street 2:244 HIGHWATCH RD
Practice Address - City:EFFINGHAM
Practice Address - State:NH
Practice Address - Zip Code:03882
Practice Address - Country:US
Practice Address - Phone:866-652-8889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-23
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME201233363LF0000X
NH083784-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily