Provider Demographics
NPI:1427268689
Name:SILK, EVELYN LOUISE (NURSE PRACTITIONER)
Entity type:Individual
Prefix:PROF
First Name:EVELYN
Middle Name:LOUISE
Last Name:SILK
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:EVELYN
Other - Middle Name:LOUISE
Other - Last Name:MCNITT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NURSE PRACTITIONER
Mailing Address - Street 1:1168 WALES PL
Mailing Address - Street 2:
Mailing Address - City:CARDIFF BY THE SEA
Mailing Address - State:CA
Mailing Address - Zip Code:92007-1512
Mailing Address - Country:US
Mailing Address - Phone:760-943-0011
Mailing Address - Fax:951-695-0133
Practice Address - Street 1:113 S VINE ST
Practice Address - Street 2:SUITE A
Practice Address - City:FALLBROOK
Practice Address - State:CA
Practice Address - Zip Code:92028-2925
Practice Address - Country:US
Practice Address - Phone:760-723-2313
Practice Address - Fax:760-723-0333
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP2982363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health