Healthcare Provider Details

I. General information

NPI: 1982934410
Provider Name (Legal Business Name): KAREN WILLIAMS EVANS RN,FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2010
Last Update Date: 01/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 KINGOLD BLVD SUITE B
SNOW HILL NC
28580-1303
US

IV. Provider business mailing address

227 KINGOLD BLVD SUITE B
SNOW HILL NC
28580-1303
US

V. Phone/Fax

Practice location:
  • Phone: 252-747-8181
  • Fax: 252-747-8946
Mailing address:
  • Phone: 252-747-8181
  • Fax: 252-747-8946

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number212106
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number212106
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number212106
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number212106
License Number StateNC
# 5
Primary TaxonomyN
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License Number212106
License Number StateNC
# 6
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number5005019
License Number StateNC
# 7
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5005019
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: