MEDICARE: KEYANNA MARIE EVANS MSW, LSW

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
1	104100000X	Social Worker	33008544A	IN
2	1041C0700X	Clinical Social Worker	7641	TN
3	1041C0700X	Clinical Social Worker	34009117A	IN

General Provider Information

NPI Number	:	1497230304
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEYANNA MARIE EVANS MSW, LSW

Provider Business Mailing Address
First Line	:	6339 CHARLOTTE PIKE # 589
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37209-2926
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6339 CHARLOTTE PIKE # 589
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37209-2926
Country	:	US
Telephone Number	:	615-212-9216
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2018
Last Update Date	:	07/05/2025

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