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General NPI Number Information
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NPI Number | 1821891961
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Entity Type | Individual
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Provider Name | EVAN SMILLIE DNP, CRNA
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Gender | Male
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Dates
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Enumeration Date | 03/31/2025
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Last Update Date | 06/04/2025
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Provider Practice Location Address
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Address Line | 720 N LINCOLN ST
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City | GREENSBURG
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State | IN
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Zip | 47240-1398
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Country | US
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Telephone | 812-663-4331
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Fax |
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Provider Business Mailing Address
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Address Line | 6033 E MEADOW RIDGE RD
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City | COLUMBUS
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State | IN
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Zip | 47203-9021
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Country | US
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Telephone | 317-871-1541
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 28240155A
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License Number State | IN
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