Healthcare Provider Details

I. General information

NPI: 1861880601
Provider Name (Legal Business Name): CINDY DAWN EVANS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/01/2015
Last Update Date: 05/16/2022
Certification Date: 05/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13345 ILLINOIS ST
CARMEL IN
46032-3318
US

IV. Provider business mailing address

13345 ILLINOIS ST
CARMEL IN
46032-3318
US

V. Phone/Fax

Practice location:
  • Phone: 317-396-1300
  • Fax: 317-352-3417
Mailing address:
  • Phone: 317-396-1300
  • Fax: 317-352-3417

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number71005388A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number71005388A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: