Evenson, Mary L

Evenson, Mary L is an individual health care provider with primary practice located at 752 N High Point Rd Dean Medical Center, Madison WI 53717-2236. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Evenson, Mary L can be contacted via phone (608) 824-4000.

Contact Information

Primary practice address
752 N High Point Rd Dean Medical Center Madison WI 53717-2236
Fax: (608) 824-4910
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 1019-023 Wisconsin

Profile Details

NPI number 1659366565
LBN Legal business name Evenson, Mary L
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 16th, 2005
Last updated Dec 23rd, 2008 - about 16 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 1659366565 NPPES
Other 60842 DEAN HEALTH INSURANCE
MEDICAID 42990900 DEAN HEALTH INSURANCE

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