| Doctor Name: | KIMBERLY R EVANS |
| NPI Number: | 1851635619 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PMHNP |
| License Number: | 0024170986 |
| Business Practice Address: | 77 Nealy Avenue 633d Medical Group Joint Base Langley-eustis, VA - 236652040 |
| Business Phone Number: | 7577646840 |
| Business Fax Number: | |
| Mailing Address: | 77 Nealy Avenue, 633d Medical Group JOINT BASE LANGLEY-EUSTIS |
| State: | VA |
| Postal Code: | 236652040 |
| Phone Number: | 7577646840 |
| Fax Number: | |
| NPI Enumeration Date: | 11/19/2012 |
| NPI Last Update Date: | 07/18/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | 0024170986 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |