Healthcare Provider Details

I. General information

NPI: 1699233320
Provider Name (Legal Business Name): CAMEKA F EVANS CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2019
Last Update Date: 03/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1725 SPRING HILL AVE
MOBILE AL
36604-1402
US

IV. Provider business mailing address

203 HERITAGE CIR
MOBILE AL
36608-8013
US

V. Phone/Fax

Practice location:
  • Phone: 251-435-1366
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-114390
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: