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NPI Code Detail

MEDICARE: JENNIFER L EVON

MEDICARE:   JENNIFER L EVON
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
1174H00000XHealth Educator

General Provider Information

NPI Number : 1548141179
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER L EVON
Provider Business Mailing Address
First Line : 14700 TIREMAN ST APT 2
Second Line :
City : DETROIT
State : MI
Zip : 48228-2757
Country : US
Telephone Number : 313-439-0442
Fax Number : 313-439-0442
Provider Business Practice Location Address
First Line : 14700 TIREMAN ST APT 2
Second Line :
City : DETROIT
State : MI
Zip : 48228-2757
Country : US
Telephone Number : 313-439-0442
Fax Number : 313-439-0442
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/10/2025
Last Update Date : 09/10/2025

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Directions to “ JENNIFER L EVON ” Practice Location

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