| Doctor Name: | MRS. HENRIETTA VALAIR EVANS |
| NPI Number: | 1366768277 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PMHNP-BC, GNP-BC |
| License Number: | AP118936 |
| Business Practice Address: | 20902 Kransburg Ridge Dr Porter, TX - 773653584 |
| Business Phone Number: | 8324928207 |
| Business Fax Number: | 8324425044 |
| Mailing Address: | 20902 Kransburg Ridge Dr, PORTER |
| State: | TX |
| Postal Code: | 773653584 |
| Phone Number: | 8324928207 |
| Fax Number: | 8324425044 |
| NPI Enumeration Date: | 04/16/2010 |
| NPI Last Update Date: | 02/06/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LG0600X |
| License Number: | AP118936 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Gerontology |
| Taxonomy Definition: | |