Healthcare Provider Details

I. General information

NPI: 1245446178
Provider Name (Legal Business Name): JANICE E. EVANS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7101 PROSPECT PL NE
ALBUQUERQUE NM
87110-4332
US

IV. Provider business mailing address

7101 PROSPECT PL NE
ALBUQUERQUE NM
87110-4332
US

V. Phone/Fax

Practice location:
  • Phone: 505-878-0177
  • Fax: 505-888-0477
Mailing address:
  • Phone: 505-878-0177
  • Fax: 505-888-0477

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberNM89-31
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License NumberNM89-31
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: