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General NPI Number Information
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NPI Number | 1619895331
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Entity Type | Individual
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Provider Name | DAISHA NICHOLE EVANS
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Gender | Female
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Dates
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Enumeration Date | 07/09/2026
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Last Update Date | 07/09/2026
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Provider Practice Location Address
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Address Line | 2905 BREEZEWOOD AVE
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City | FAYETTEVILLE
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State | NC
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Zip | 28303-5503
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Country | US
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Telephone | 180-498-5105
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Fax | 180-498-5105
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Provider Business Mailing Address
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Address Line | 276 LEGACY LN
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City | LILLINGTON
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State | NC
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Zip | 27546-7281
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Country | US
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Telephone | 919-830-9274
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Fax | 919-830-9274
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State | NC
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