Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2200X | Nurse Practitioner - Adult Health | 18931 | SC |
N | 363LG0600X | Nurse Practitioner - Gerontology | 18931 | SC |
Y | 363LP2300X | Nurse Practitioner - Primary Care | 18931 | SC |
NPI | 1053716142 |
---|---|
Provider Name | Evelyn Leteshia Frank |
First Address | Baltimore, MD 21201-7912 |
Second Address | Baltimore, MD 21201-7912 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2014 |
Last Update Date | 09/07/2015 |