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General NPI Number Information
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NPI Number | 1770321952
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Entity Type | Individual
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Provider Name | AMY DEEANN EVANS FNP-C
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Gender | Female
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Dates
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Enumeration Date | 07/19/2024
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Last Update Date | 11/11/2024
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Provider Practice Location Address
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Address Line | 105 MEDICAL DRIVE
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City | SEGUIN
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State | TX
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Zip | 78155
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Country | US
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Telephone | 830-484-4204
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Fax | 830-386-0239
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Provider Business Mailing Address
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Address Line | 237 GREAT OAKS BLVD
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City | LA VERNIA
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State | TX
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Zip | 78121-4677
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Country | US
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Telephone | 936-327-1886
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1169462
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License Number State | TX
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