MEDICARE: JENNIFER 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
1	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1841876158
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER EVANS

Provider Business Mailing Address
First Line	:	9900 N CENTRAL EXPY STE 500
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-0928
Country	:	US
Telephone Number	:	214-987-3376
Fax Number	:	469-532-0273

Provider Business Practice Location Address
First Line	:	3010 W CHARLESTON BLVD STE 100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-1969
Country	:	US
Telephone Number	:	702-933-0225
Fax Number	:	702-258-3455

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

Provider Enumeration Date	:	03/18/2021
Last Update Date	:	02/10/2026

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Directions to “ JENNIFER EVANS ” Practice Location

Language	Start Address	Practice Location

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