Healthcare Provider Details

I. General information

NPI: 1841643525
Provider Name (Legal Business Name): BRIDGET A EVANS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2016
Last Update Date: 11/26/2025
Certification Date: 11/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 PLEASANT VALLEY RD
OWENSBORO KY
42303-9811
US

IV. Provider business mailing address

PO BOX 23229
OWENSBORO KY
42304-3229
US

V. Phone/Fax

Practice location:
  • Phone: 270-417-4700
  • Fax: 270-417-4709
Mailing address:
  • Phone: 270-691-8070
  • Fax: 270-691-8026

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3010815
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: