Provider Demographics
NPI:1851650303
Name:FLUENT, EVELYN MAE (LPN)
Entity type:Individual
Prefix:MISS
First Name:EVELYN
Middle Name:MAE
Last Name:FLUENT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4297 DAVIS HILL RD
Mailing Address - Street 2:
Mailing Address - City:SCIO
Mailing Address - State:NY
Mailing Address - Zip Code:14880-9502
Mailing Address - Country:US
Mailing Address - Phone:716-498-3035
Mailing Address - Fax:
Practice Address - Street 1:83 PINE ST
Practice Address - Street 2:
Practice Address - City:WELLSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14895-1421
Practice Address - Country:US
Practice Address - Phone:585-593-6052
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-03
Last Update Date:2012-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY298316-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse