Evangelina Pavelik Miller, FNP-C

Individual provider Active NPI Family Nurse Practitioner · Benson, AZ

NPI 1144599515 · NPPES record last updated Sep 16, 2013

Key facts

NPI
1144599515
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
AP4315 (AZ)
Practice address
890 W 4TH St
Benson, AZ 85602-6437
Phone
(520) 586-3664
NPI assigned
Dec 14, 2011
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP4315 AZ Yes

Addresses

Primary practice location

890 W 4TH St
Benson, AZ 85602-6437

Mailing address

2202 N Forbes Blvd
Tucson, AZ 85745-1412
Phone (520) 872-7536

Other providers in Benson, AZ

All providers in Benson, AZ · Family Nurse Practitioner in Arizona

Sources for this page

Verify at the official NPI Registry.