Healthcare Provider Details

I. General information

NPI: 1942293154
Provider Name (Legal Business Name): REBECCA BERRIER EVANS CNM, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2005
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

958A JOE FRANK HARRIS PKWY SE STE 102
CARTERSVILLE GA
30120-2129
US

IV. Provider business mailing address

958A JOE FRANK HARRIS PKWY SE STE 102
CARTERSVILLE GA
30120-2129
US

V. Phone/Fax

Practice location:
  • Phone: 678-605-9371
  • Fax: 678-605-9392
Mailing address:
  • Phone: 678-605-9371
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN145456
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberRN145456
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: