Healthcare Provider Details

I. General information

NPI: 1841868353
Provider Name (Legal Business Name): KYRA EVANS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2021
Last Update Date: 05/16/2026
Certification Date: 05/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2045 DIXWELL AVE
HAMDEN CT
06514-2405
US

IV. Provider business mailing address

2045 DIXWELL AVE
HAMDEN CT
06514-2405
US

V. Phone/Fax

Practice location:
  • Phone: 866-389-2727
  • Fax:
Mailing address:
  • Phone: 866-389-2727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number9720
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9720
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: