Provider Demographics
NPI:1316819683
Name:WITHROW, EVELYN JOLIE
Entity type:Individual
Prefix:
First Name:EVELYN
Middle Name:JOLIE
Last Name:WITHROW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 MEADOWLARK LN
Mailing Address - Street 2:
Mailing Address - City:RIPLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25271-9321
Mailing Address - Country:US
Mailing Address - Phone:681-341-2955
Mailing Address - Fax:
Practice Address - Street 1:19 MEADOWLARK LN
Practice Address - Street 2:
Practice Address - City:RIPLEY
Practice Address - State:WV
Practice Address - Zip Code:25271-9321
Practice Address - Country:US
Practice Address - Phone:681-341-2955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-18
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant