Evelyn Anderson, CRNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

SP028239 Issued in PA

Practice address

110 Campus Dr
Bradford, PA 16701-1982

Phone

(814) 362-6536

Fax

(814) 817-2115

NPI assigned

Sep 15, 2023

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

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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

• The Guidance Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bradford, PA
  • NPI 1831256015
  Medicare reassignment NPD
• The Guidance Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bradford, PA
  • NPI 1497740856
  NPD (past)
• The Guidance Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bradford, PA
  • NPI 1720145915
  NPD (past)

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

{
    "created_epoch": "1694736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694736000000",
    "number": "1881472587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 CAMPUS DR",
            "city": "BRADFORD",
            "state": "PA",
            "postal_code": "167011982",
            "telephone_number": "814-362-6536",
            "fax_number": "814-817-2115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 CAMPUS DR",
            "city": "BRADFORD",
            "state": "PA",
            "postal_code": "167011982",
            "telephone_number": "814-362-6536",
            "fax_number": "814-817-2115"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "415 W Main St",
            "address_purpose": "LOCATION",
            "city": "Smethport",
            "state": "PA",
            "postal_code": "167491154",
            "country_code": "US",
            "telephone_number": "814-362-6536",
            "fax_number": "814-817-2115",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "308 Market St",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "PA",
            "postal_code": "163652391",
            "country_code": "US",
            "telephone_number": "814-362-6536",
            "fax_number": "814-817-2115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "EVELYN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-15",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP028239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sayed Shaheer Alamy, MD
• Rebecca L Alborn
• Grant Daniel Allen, PHARMACIST
• Jacqueline Michelle Allen, MS CCCSLP
• Syed A Ally, MD
• Kelli Anderson, LDN
• Tracy Lynn Andrus, PA-C
• Anesthetix of Bradford, LLC
• Cheryl A Antle, RN
• Apria Healthcare LLC

• Psychiatric/Mental Health Nurse Practitioner in Bradford, PA
• Providers in Bradford, PA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.