Healthcare Provider Details

I. General information

NPI: 1003979410
Provider Name (Legal Business Name): EVELYN MARIE DREYER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 11/03/2023
Certification Date: 11/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 JUBILEE DR
PEABODY MA
01960-4068
US

IV. Provider business mailing address

PO BOX 1241
TACOMA WA
98401-1241
US

V. Phone/Fax

Practice location:
  • Phone: 877-341-9606
  • Fax:
Mailing address:
  • Phone: 253-383-8342
  • Fax: 253-404-0506

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP30007516
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: