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NPI Code Detail

MEDICARE: CARLYN EVANS

MEDICARE: CARLYN EVANS
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1376060533
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARLYN EVANS
Provider Business Mailing Address
First Line : 1247A KENMORE PL
Second Line :
City : NASHVILLE
State : TN
Zip : 37216-3214
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 230 GREAT CIRCLE RD STE 202
Second Line :
City : NASHVILLE
State : TN
Zip : 37228-1710
Country : US
Telephone Number : 615-226-2840
Fax Number : 615-226-2839
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2017
Last Update Date : 08/28/2017

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Directions to “ CARLYN EVANS ” Practice Location

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