MEDICARE: DAVID LINN EVANS ARNP-BC

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
1	363LP0222X	Critical Care Pediatric Nurse Practitioner	553	AK

General Provider Information

NPI Number	:	1376771436
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID LINN EVANS ARNP-BC

Provider Business Mailing Address
First Line	:	5420 VINEWOOD
Second Line	:
City	:	FALLON
State	:	NV
Zip	:	89406-4299
Country	:	US
Telephone Number	:	775-423-9515
Fax Number	:	781-459-6148

Provider Business Practice Location Address
First Line	:	5420 VINEWOOD
Second Line	:
City	:	FALLON
State	:	NV
Zip	:	89406-4299
Country	:	US
Telephone Number	:	775-423-9515
Fax Number	:	781-459-6148

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/29/2009
Last Update Date	:	06/29/2009

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Directions to “ DAVID LINN EVANS ARNP-BC” Practice Location

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