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NPI Code Detail

MEDICARE: MRS. MARCI EVANS MS, RD

MEDICARE: MRS. MARCI EVANS MS, RD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian932558MA

General Provider Information

NPI Number : 1114159191
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARCI EVANS MS, RD
Provider Business Mailing Address
First Line : 22 HILLIARD ST
Second Line :
City : CAMBRIDGE
State : MA
Zip : 02138-4972
Country : US
Telephone Number : 617-834-7336
Fax Number :
Provider Business Practice Location Address
First Line : 22 HILLIARD ST
Second Line :
City : CAMBRIDGE
State : MA
Zip : 02138-4972
Country : US
Telephone Number : 480-889-4943
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2009
Last Update Date : 02/12/2021

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