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NPI Code Detail

MEDICARE: MS. ELIZABETH EVANS L.V.N.

MEDICARE: MS. ELIZABETH EVANS L.V.N.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164X00000XLicensed Vocational Nurse167180CA

General Provider Information

NPI Number : 1003142464
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ELIZABETH EVANS L.V.N.
Provider Business Mailing Address
First Line : 2603 LAS MERCEDES LANE
Second Line :
City : CORONA
State : CA
Zip : 92880
Country : US
Telephone Number : 714-262-6201
Fax Number : 949-361-1669
Provider Business Practice Location Address
First Line : 2603 LAS MERCEDES LN
Second Line :
City : CORONA
State : CA
Zip : 92879-7798
Country : US
Telephone Number : 714-262-6201
Fax Number : 949-361-1669
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2009
Last Update Date : 10/20/2009

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