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NPI Code Detail

MEDICARE: KATHLEEN EVANINA NP

MEDICARE: KATHLEEN EVANINA NP
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
1363L00000XNurse PractitionerSP008273PA

General Provider Information

NPI Number : 1427024710
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHLEEN EVANINA NP
Provider Business Mailing Address
First Line : 907 E SCOTT ST
Second Line :
City : OLYPHANT
State : PA
Zip : 18447-2127
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 829 SCRANTON CARBONDALE HWY
Second Line :
City : EYNON
State : PA
Zip : 18403-1020
Country : US
Telephone Number : 570-383-0825
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2006
Last Update Date : 12/02/2025

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