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General NPI Number Information
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NPI Number | 1427830876
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Entity Type | Individual
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Provider Name | PEYTON EVANS
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Gender | Female
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Dates
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Enumeration Date | 10/19/2023
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Last Update Date | 10/19/2023
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Provider Practice Location Address
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Address Line | 711 N MAIN ST
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City | CAVE CITY
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State | AR
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Zip | 72521-9103
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Country | US
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Telephone | 870-834-5684
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Fax |
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Provider Business Mailing Address
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Address Line | 98 LAW 277
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City | SMITHVILLE
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State | AR
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Zip | 72440
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Country | US
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Telephone |
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number |
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License Number State |
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