Evelyn Louise Pedersen, N. P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024111409 Issued in VA

Practice address

281 Independence Blvd
Suite 326
Virginia Beach, VA 23462-2986

Phone

(757) 490-0377

Fax

(757) 490-1327

NPI assigned

May 29, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447451596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 MIDDLE GIBBS RD",
            "city": "KNOTTS ISLAND",
            "state": "NC",
            "postal_code": "279509749",
            "telephone_number": "252-435-6489",
            "fax_number": "252-435-6489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "281 INDEPENDENCE BLVD",
            "address_2": "SUITE 326",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234622986",
            "telephone_number": "757-490-0377",
            "fax_number": "757-490-1327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSEN",
        "first_name": "EVELYN",
        "middle_name": "LOUISE",
        "credential": "N. P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024111409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kiersten Pease
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• Emily Elizabeth Peden
• Pediatric Dental Care of Tidewater PC (Weis Orthodontics)
• Pediatrics of Kempsville, P.C.
• Ramoncito Valencia Pedro, SUB-IDC
• Yolanda Vazquez Pedroza, MS. CCC-SLP
• Laniesha Denise Peebles

• Family Nurse Practitioner in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.