Healthcare Provider Details

I. General information

NPI: 1538411889
Provider Name (Legal Business Name): EVERCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2012
Last Update Date: 10/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4051 OGLETOWN RD
NEWARK DE
19713-3101
US

IV. Provider business mailing address

1415 RIVER RD
DRUMORE PA
17518-9775
US

V. Phone/Fax

Practice location:
  • Phone: 302-943-0426
  • Fax:
Mailing address:
  • Phone: 302-943-0426
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberLG-0000614
License Number StateDE

VIII. Authorized Official

Name: MRS. JENNIFER ANN TURPEN
Title or Position: NURSE PRACTITIONER
Credential: CRNP, APN, FNP-BC
Phone: 302-943-0426