Provider Demographics
NPI:1710667829
Name:NOEL, EVELYN (APRN, PMHNP)
Entity type:Individual
Prefix:MISS
First Name:EVELYN
Middle Name:
Last Name:NOEL
Suffix:
Gender:F
Credentials:APRN, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 N STATE ROAD 7 STE 312
Mailing Address - Street 2:
Mailing Address - City:LAUDERDALE LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33319-4871
Mailing Address - Country:US
Mailing Address - Phone:954-289-4098
Mailing Address - Fax:954-361-1514
Practice Address - Street 1:4000 N STATE ROAD 7 STE 312
Practice Address - Street 2:
Practice Address - City:LAUDERDALE LAKES
Practice Address - State:FL
Practice Address - Zip Code:33319-4871
Practice Address - Country:US
Practice Address - Phone:954-740-3080
Practice Address - Fax:954-361-1514
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-24
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN1027505101YM0800X
FLAPRN11027505363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health