Doctor Name: | MRS. EVANGELINA PAVELIK MILLER |
NPI Number: | 1144599515 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-C |
License Number: | AP4315 |
Business Practice Address: | 890 W 4th St Benson, AZ - 856026437 |
Business Phone Number: | 5205863664 |
Business Fax Number: | |
Mailing Address: | 2202 N Forbes Blvd, TUCSON |
State: | AZ |
Postal Code: | 857451412 |
Phone Number: | 5208727536 |
Fax Number: | 5208727929 |
NPI Enumeration Date: | 12/14/2011 |
NPI Last Update Date: | 09/16/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | AP4315 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |