Provider Demographics
NPI:1538632344
Name:FLANAGAN, EVELINA (PA-C)
Entity type:Individual
Prefix:MRS
First Name:EVELINA
Middle Name:
Last Name:FLANAGAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:EVELINA
Other - Middle Name:
Other - Last Name:VASILIAUSKAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1893 E 119TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-1988
Mailing Address - Country:US
Mailing Address - Phone:708-334-1861
Mailing Address - Fax:
Practice Address - Street 1:9500 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-1434
Practice Address - Country:US
Practice Address - Phone:216-339-2575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-03
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.005991RX363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant