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General NPI Number Information
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NPI Number | 1730980541
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Entity Type | Individual
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Provider Name | LISA ANN EVANS RN
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Gender | Female
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Dates
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Enumeration Date | 03/19/2025
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Last Update Date | 03/19/2025
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Provider Practice Location Address
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Address Line | 1311 BRANDYWINE BLVD
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City | WILMINGTON
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State | DE
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Zip | 19809-2306
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Country | US
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Telephone | 302-454-2400
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Fax |
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Provider Business Mailing Address
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Address Line | 25 CABOT CT
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City | MEDIA
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State | PA
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Zip | 19063-5525
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Country | US
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Telephone | 610-733-0587
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | L1-0041999
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License Number State | DE
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