Healthcare Provider Details

I. General information

NPI: 1801776943
Provider Name (Legal Business Name): KATRICE TRENAY EVANS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2025
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3293 BRATER AVE
CINCINNATI OH
45238-2101
US

IV. Provider business mailing address

3293 BRATER AVE
CINCINNATI OH
45238-2101
US

V. Phone/Fax

Practice location:
  • Phone: 513-975-7564
  • Fax:
Mailing address:
  • Phone: 513-975-7464
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number188492
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License NumberSM149570
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: