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General NPI Number Information
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NPI Number | 1083918643
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Entity Type | Individual
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Provider Name | ELIZABETH EVANS APRN
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Gender | Female
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Dates
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Enumeration Date | 12/22/2010
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Last Update Date | 11/22/2019
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Provider Practice Location Address
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Address Line | 1131 S CLIFTON AVE
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City | WICHITA
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State | KS
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Zip | 67218-2955
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Country | US
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Telephone | 316-866-2000
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Fax | 316-866-2084
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Provider Business Mailing Address
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Address Line | 1131 S CLIFTON SUITE B
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City | WICHITA
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State | KS
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Zip | 67218
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Country | US
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Telephone | 316-462-1040
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | TEP-142175
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License Number State | KS
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