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General NPI Number Information
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NPI Number | 1821636606
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Entity Type | Individual
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Provider Name | JENNA EVANS APRN
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Gender | Female
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Dates
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Enumeration Date | 12/12/2019
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Last Update Date | 02/11/2025
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Provider Practice Location Address
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Address Line | 301 GORDON GUTMANN BLVD STE 101
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City | JEFFERSONVILLE
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State | IN
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Zip | 47130-3765
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Country | US
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Telephone | 812-282-4844
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Fax | 812-282-6248
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Provider Business Mailing Address
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Address Line | PO BOX 776351
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City | CHICAGO
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State | IL
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Zip | 60677-6351
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Country | US
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Telephone | 502-588-9490
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Fax | 502-272-5116
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 1134874
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 28191999A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 3014096
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License Number State | KY
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 71009865A
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License Number State | IN
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