| Doctor Name: | MRS. MARY ANN EVANS |
| NPI Number: | 1003179888 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN4 |
| License Number: | RN066385 |
| Business Practice Address: | 1035 Creswell Ave Shreveport, LA - 711013917 |
| Business Phone Number: | 3186765286 |
| Business Fax Number: | 3186765221 |
| Mailing Address: | 538 Corrine Pl, WASKOM |
| State: | TX |
| Postal Code: | 756925008 |
| Phone Number: | 9036873939 |
| Fax Number: | |
| NPI Enumeration Date: | 06/18/2012 |
| NPI Last Update Date: | 06/18/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WC1500X |
| License Number: | RN066385 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Community Health |
| Taxonomy Definition: | |