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General NPI Number Information
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NPI Number | 1760205983
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Entity Type | Individual
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Provider Name | BAMBI EVANS
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Gender | Female
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Dates
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Enumeration Date | 11/05/2024
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Last Update Date | 09/27/2025
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Provider Practice Location Address
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Address Line | 388 BEN BOLT AVE STE 4
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City | TAZEWELL
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State | VA
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Zip | 24651-5386
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Country | US
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Telephone | 276-979-9899
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Fax |
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Provider Business Mailing Address
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Address Line | 388 BEN BOLT AVE STE 4
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City | TAZEWELL
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State | VA
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Zip | 24651-5386
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Country | US
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Telephone | 276-979-9888
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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 | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number | 0001283201
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License Number State | VA
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