| Doctor Name: | WHITNEY EVANS |
| NPI Number: | 1063885440 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CNP |
| License Number: | CNP 4248 |
| Business Practice Address: | 2017 Coon Rapids Blvd Nw Coon Rapids, MN - 554334121 |
| Business Phone Number: | 8663892727 |
| Business Fax Number: | |
| Mailing Address: | 4501 Park Glen Rd, Apt 241 ST LOUIS PARK |
| State: | MN |
| Postal Code: | 554165829 |
| Phone Number: | 7159370548 |
| Fax Number: | |
| NPI Enumeration Date: | 11/05/2015 |
| NPI Last Update Date: | 11/05/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | CNP 4248 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |