Healthcare Provider Details

I. General information

NPI: 1376037481
Provider Name (Legal Business Name): LAUREN E EVANS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2018
Last Update Date: 03/17/2021
Certification Date: 03/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 FREEPORT RD
PITTSBURGH PA
15215-3301
US

IV. Provider business mailing address

625 WALNUT ST
MCKEESPORT PA
15132-2806
US

V. Phone/Fax

Practice location:
  • Phone: 412-784-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT026876
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT026876
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: