Provider Demographics
NPI:1154950152
Name:MENSAH, EVELYN (CRNP)
Entity type:Individual
Prefix:
First Name:EVELYN
Middle Name:
Last Name:MENSAH
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 BETHEL DR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-2435
Mailing Address - Country:US
Mailing Address - Phone:717-318-1705
Mailing Address - Fax:
Practice Address - Street 1:2501 OREGON PIKE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-4890
Practice Address - Country:US
Practice Address - Phone:717-735-1954
Practice Address - Fax:717-569-3045
Is Sole Proprietor?:No
Enumeration Date:2020-04-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP021731363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103764595Medicaid
14657908OtherCAQH ID
PARN684708OtherSTATE LICENSE - RN
PASP021731OtherSTATE LICENSE - CRNP
PASP021731OtherSTATE LICENSE - CRNP