Healthcare Provider Details

I. General information

NPI: 1760123095
Provider Name (Legal Business Name): CARRIE F EVANS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2022
Last Update Date: 04/01/2022
Certification Date: 03/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

281 SAWYER DR STE 300
DURANGO CO
81303-3412
US

IV. Provider business mailing address

281 SAWYER DR STE 300
DURANGO CO
81303-3412
US

V. Phone/Fax

Practice location:
  • Phone: 970-585-6134
  • Fax: 970-247-9126
Mailing address:
  • Phone: 970-585-6134
  • Fax: 970-247-9126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN0184836
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: