Doctor Name: | MRS. MICHELLE L EVANS |
NPI Number: | 1265772347 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CNP |
License Number: | 14309 |
Business Practice Address: | 2346 Walker Mill Rd Poland, OH - 445143658 |
Business Phone Number: | 3305091146 |
Business Fax Number: | |
Mailing Address: | 2346 Walker Mill Rd, POLAND |
State: | OH |
Postal Code: | 445143658 |
Phone Number: | 3305091146 |
Fax Number: | |
NPI Enumeration Date: | 02/26/2013 |
NPI Last Update Date: | 02/26/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | 14309 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |