Provider Demographics
NPI:1447796966
Name:GODWIN, EVELYN A (RN)
Entity type:Individual
Prefix:MS
First Name:EVELYN
Middle Name:A
Last Name:GODWIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89 PLYMOUTH DR
Mailing Address - Street 2:#2D
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062-5433
Mailing Address - Country:US
Mailing Address - Phone:703-819-6611
Mailing Address - Fax:
Practice Address - Street 1:89 PLYMOUTH DR
Practice Address - Street 2:#2D
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-5433
Practice Address - Country:US
Practice Address - Phone:703-819-6611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-07
Last Update Date:2017-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA157757163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical