Evans, Jacquelyn R

Evans, Jacquelyn R is an individual health care provider with primary practice located at 3401 Civic Center Blvd Children'S Hospital Of Philadelphia - Neonatology, Philadelphia PA 19104-4319. She recently has only one registered license in Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine, which is considered as her primary health care specialty. Evans, Jacquelyn R can be contacted via phone (215) 590-1944.

Contact Information

Primary practice address
3401 Civic Center Blvd Children'S Hospital Of Philadelphia - Neonatology Philadelphia PA 19104-4319
Phone: (215) 590-1944
Fax: (215) 590-4454
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine 2080N0001X MD053430L Pennsylvania

Profile Details

NPI number 1043255334
LBN Legal business name Evans, Jacquelyn R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 19th, 2006
Last updated May 16th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043255334 NPPES
New Jersey MEDICAID 6337007
New Jersey MEDICAID 0014807880003

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