1295253243 NPI number — EVOLUTION AMBULANCE INC.

Table of content: MS. AISHA RICHELLE BROWNLEE APRN, CNP (NPI 1124303383)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295253243 NPI number — EVOLUTION AMBULANCE INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EVOLUTION AMBULANCE INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1295253243
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/16/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
410 CALLE ROBLE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
JUNCOS
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00777-9439
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-685-4246
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
URB VILLA CAROLINA
Provider Second Line Business Practice Location Address:
47 CALLE 40
Provider Business Practice Location Address City Name:
CAROLINA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00987
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-685-4246
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/30/2017

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
DE JESUS
Authorized Official First Name:
FRANSHESKA
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
787-685-4246

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)