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General NPI Number Information
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NPI Number | 1952831497
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Entity Type | Individual
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Provider Name | MS. NINA MARIE EVANS
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Gender | Female
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Dates
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Enumeration Date | 06/18/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 6815 W. CAPITOL DRIVE SUITE 117
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City | MILWAUKEE
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State | WI
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Zip | 53216
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Country | US
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Telephone | 414-204-8599
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Fax | 414-204-8535
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Provider Business Mailing Address
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Address Line | 6815 W CAPITOL DR STE 117
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City | MILWAUKEE
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State | WI
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Zip | 53216-2056
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Country | US
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Telephone | 414-204-8599
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Fax | 414-204-8535
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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 | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State | WI
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