Healthcare Provider Details

I. General information

NPI: 1609806066
Provider Name (Legal Business Name): CYNTHIA N EVANS CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 03/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 MARTLING RD
ALBERTVILLE AL
35951-7209
US

IV. Provider business mailing address

415 MARTLING RD
ALBERTVILLE AL
35951-7209
US

V. Phone/Fax

Practice location:
  • Phone: 256-660-5560
  • Fax: 256-660-5564
Mailing address:
  • Phone: 256-660-5560
  • Fax: 256-660-5564

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number1023585
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: