Healthcare Provider Details

I. General information

NPI: 1053248518
Provider Name (Legal Business Name): ANDREIA Y EVANS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2350 MONROE ST APT 303
TOLEDO OH
43604-5091
US

IV. Provider business mailing address

2350 MONROE ST APT 303
TOLEDO OH
43604-5091
US

V. Phone/Fax

Practice location:
  • Phone: 419-870-2992
  • Fax: 419-870-2992
Mailing address:
  • Phone: 419-870-2992
  • Fax: 419-870-2992

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: