Healthcare Provider Details

I. General information

NPI: 1548938624
Provider Name (Legal Business Name): CECILY KARYN HEATH EVANS MSN, APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2021
Last Update Date: 11/11/2025
Certification Date: 11/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 N 3RD ST
LONGVIEW TX
75601-6546
US

IV. Provider business mailing address

2001 N JEFFERSON AVE
MOUNT PLEASANT TX
75455-2338
US

V. Phone/Fax

Practice location:
  • Phone: 903-475-3474
  • Fax: 903-367-0300
Mailing address:
  • Phone: 903-577-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1053391
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: