Healthcare Provider Details

I. General information

NPI: 1134148943
Provider Name (Legal Business Name): MAEGAN K EVANS PH.D. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

808 BACON ST
DURHAM NC
27703-5006
US

IV. Provider business mailing address

808 BACON ST
DURHAM NC
27703-5006
US

V. Phone/Fax

Practice location:
  • Phone: 919-560-2096
  • Fax: 919-560-2162
Mailing address:
  • Phone: 919-560-2096
  • Fax: 919-560-2162

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number7511
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: