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General NPI Number Information
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NPI Number | 1417206186
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Entity Type | Individual
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Provider Name | MICHELE ANN EVANS CNP
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Gender | Female
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Dates
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Enumeration Date | 09/10/2012
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Last Update Date | 09/10/2012
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Provider Practice Location Address
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Address Line | 6001 E BROAD ST
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City | COLUMBUS
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State | OH
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Zip | 43213-1502
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Country | US
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Telephone | 614-234-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 18 MURPHYS VIEW PL
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City | POWELL
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State | OH
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Zip | 43065-6032
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Country | US
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Telephone | 614-406-1762
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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 | 163WN0002X
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Taxonomy Name | Neonatal Intensive Care Registered Nurse
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License Number | 307548
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363LN0005X
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Taxonomy Name | Critical Care Neonatal Nurse Practitioner
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License Number | 13781-NP
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License Number State | OH
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