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General NPI Number Information
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NPI Number | 1962246157
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Entity Type | Individual
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Provider Name | AWNA JONAE EVICKS RN
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Gender | Female
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Dates
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Enumeration Date | 06/21/2024
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Last Update Date | 06/21/2024
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Provider Practice Location Address
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Address Line | 500 N SANTA FE ST
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City | VISALIA
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State | CA
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Zip | 93292-5065
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Country | US
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Telephone | 559-684-8703
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Fax |
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Provider Business Mailing Address
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Address Line | 1920 N BURL DR
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City | HANFORD
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State | CA
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Zip | 93230-2105
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Country | US
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Telephone | 559-572-7133
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 95159877
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License Number State | CA
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