Healthcare Provider Details

I. General information

NPI: 1831009869
Provider Name (Legal Business Name): NIA PRIMARY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

829 S UNIVERSITY BLVD
MOBILE AL
36609-7873
US

IV. Provider business mailing address

8831 KENSTON CT
MOBILE AL
36619-4354
US

V. Phone/Fax

Practice location:
  • Phone: 251-289-1477
  • Fax:
Mailing address:
  • Phone: 251-289-1477
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ALICIA DENISE EVANS
Title or Position: PHYSICIAN, OWNER
Credential: MD
Phone: 251-289-1477