Provider Demographics
NPI:1356720114
Name:NONATO, EVINA LUSTRIA (CPNP-PC)
Entity type:Individual
Prefix:
First Name:EVINA
Middle Name:LUSTRIA
Last Name:NONATO
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:FREYLEN EVINA
Other - Middle Name:LUSTRIA
Other - Last Name:NONATO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CPNP-PC
Mailing Address - Street 1:P.O. BOX 1347
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28603
Mailing Address - Country:US
Mailing Address - Phone:828-328-1118
Mailing Address - Fax:828-328-1119
Practice Address - Street 1:3411 GRAYSTONE PL SE
Practice Address - Street 2:
Practice Address - City:CONOVER
Practice Address - State:NC
Practice Address - Zip Code:28613-8200
Practice Address - Country:US
Practice Address - Phone:828-328-1118
Practice Address - Fax:828-328-1119
Is Sole Proprietor?:No
Enumeration Date:2015-05-27
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5007639363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics