Healthcare Provider Details

I. General information

NPI: 1619887155
Provider Name (Legal Business Name): RUBY MAE EVANS CNA, ASSOCIATE BUS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

266 TOWNSHIP ROAD 1336
SOUTH POINT OH
45680-7810
US

IV. Provider business mailing address

266 TOWNSHIP ROAD 1336
SOUTH POINT OH
45680-7810
US

V. Phone/Fax

Practice location:
  • Phone: 740-861-9206
  • Fax: 740-451-1195
Mailing address:
  • Phone: 740-861-9206
  • Fax: 740-451-1195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: