Most Relevant Information
Provider Data
| NPI Number: | 1003476888 |
| Provider Name: | MARIBETH EVANS RN, NP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LP0808X |
| Specialty: | Nurse Practitioner |
| License Number: | 402744 |
Most Important Dates
| Enumeration Date: | 06/14/2019 |
| Last Updated: | 06/29/2023 |
Provider Practice Location
1003 PARK ST
OGDENSBURG
NY
136693911
Practice Location Phone/Fax
| Phone: | 3157139090 |
| Fax: |
Provider Mailing Location
33 LEWIS RD
2ND FL
BINGHAMTON
NY
13905
Provider Mailing Phone/Fax
| Phone: | 6077298156 |
| Fax: | 6077293982 |