| NPI | 1487854873 |
|---|---|
| Former Name | EVELYN TERESA FITZSIMMONS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 3081291) |
| Additional Taxonomies | 302F00000X Exclusive Provider Organization (Licence: NY 308129-1) |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2008-08-09 |