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General NPI Number Information
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NPI Number | 1285621680
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Entity Type | Individual
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Provider Name | STEVEN W EVANS FNP
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Gender | Male
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Dates
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Enumeration Date | 09/30/2005
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Last Update Date | 09/07/2011
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Provider Practice Location Address
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Address Line | 201 W BLUE STARR DR
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City | CLAREMORE
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State | OK
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Zip | 74017-4227
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Country | US
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Telephone | 918-341-4825
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Fax | 918-341-8158
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Provider Business Mailing Address
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Address Line | 201 W BLUE STARR DR
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City | CLAREMORE
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State | OK
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Zip | 74017-4227
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Country | US
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Telephone | 918-341-4825
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Fax | 918-341-8158
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 086009
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R0084568
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License Number State | OK
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