=====================================================
General NPI Number Information
=====================================================
NPI Number | 1790693331
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TABITHA M EVANS RN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/01/2026
-----------------------------------------------------
Last Update Date | 09/01/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2385 WEDGEWOOD DR
-----------------------------------------------------
City | AKRON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44312-2401
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-761-7930
-----------------------------------------------------
Fax | 330-761-7932
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 214 W BOWERY ST
-----------------------------------------------------
City | AKRON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44308-1046
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163W00000X
-----------------------------------------------------
Taxonomy Name | Registered Nurse
-----------------------------------------------------
License Number | RN-512080
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------