Provider Demographics
NPI:1801279658
Name:STOKES-HARRIS, EVELINA T (LPN)
Entity type:Individual
Prefix:
First Name:EVELINA
Middle Name:T
Last Name:STOKES-HARRIS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 GOLD ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14206-1421
Mailing Address - Country:US
Mailing Address - Phone:716-364-1976
Mailing Address - Fax:
Practice Address - Street 1:137 GOLD ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14206-1421
Practice Address - Country:US
Practice Address - Phone:716-364-1976
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-29
Last Update Date:2015-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY320569164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse