Healthcare Provider Details

I. General information

NPI: 1558671586
Provider Name (Legal Business Name): SHEILA LYNN EVANS PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHEILA LYNN EMMS

II. Dates (important events)

Enumeration Date: 10/08/2010
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 UNIVERSITY AVE W
SAINT PAUL MN
55104-3727
US

IV. Provider business mailing address

2450 RIVERSIDE AVE
MINNEAPOLIS MN
55454-1450
US

V. Phone/Fax

Practice location:
  • Phone: 651-232-7000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number8643
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: