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NPI Code Detail

MEDICARE: MS. BRENDA JOYCE EVANS M.D.

MEDICARE:  MS. BRENDA JOYCE EVANS  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor2002032335MO

General Provider Information

NPI Number : 1477606499
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. BRENDA JOYCE EVANS M.D.
Provider Business Mailing Address
First Line : 5161 CABANNE AVE
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63113-1610
Country : US
Telephone Number : 314-479-4505
Fax Number :
Provider Business Practice Location Address
First Line : 5161 CABANNE AVE
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63113-1610
Country : US
Telephone Number : 314-479-4505
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/21/2007
Last Update Date : 07/08/2007

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Directions to “ MS. BRENDA JOYCE EVANS M.D.” Practice Location

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