Healthcare Provider Details

I. General information

NPI: 1144922394
Provider Name (Legal Business Name): ANDREW GEORGE EVANS APRN-CNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2023
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 MEDICAL CENTER PKWY
MAUMEE OH
43537-1921
US

IV. Provider business mailing address

4235 SECOR RD
TOLEDO OH
43623-4299
US

V. Phone/Fax

Practice location:
  • Phone: 419-794-7720
  • Fax: 419-724-2417
Mailing address:
  • Phone: 419-473-3561
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.472338
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN.CNP.0035007
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: