Provider Demographics
NPI:1881771897
Name:EVILSIZOR, CHRISTY L (ARNP)
Entity type:Individual
Prefix:
First Name:CHRISTY
Middle Name:L
Last Name:EVILSIZOR
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:CHRISTY
Other - Middle Name:L
Other - Last Name:WESWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1717 S J ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-4933
Mailing Address - Country:US
Mailing Address - Phone:253-534-7000
Mailing Address - Fax:253-534-7099
Practice Address - Street 1:1717 S J ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-4933
Practice Address - Country:US
Practice Address - Phone:253-534-7000
Practice Address - Fax:253-534-7099
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9277675363LA2100X
CA95009295363LA2100X
WAAP60834502363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP01159338OtherRR MEDICARE
FLBA899XMedicare PIN