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NPI Code Detail

MEDICARE: MIA EVANS APRN

MEDICARE: MIA EVANS APRN
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
1363LN0000XNeonatal Nurse Practitioner0991890-NPCO
2163W00000XRegistered Nurse182138CO
3363LN0005XCritical Care Neonatal Nurse Practitioner144823TX

General Provider Information

NPI Number : 1922294131
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIA EVANS APRN
Provider Business Mailing Address
First Line : 1121 E SPRING CREEK PKWY
Second Line : STE. 110 - #319
City : PLANO
State : TX
Zip : 75074
Country : US
Telephone Number : 214-343-6663
Fax Number : 214-343-2814
Provider Business Practice Location Address
First Line : 4400 LONG PRAIRIE RD
Second Line :
City : FLOWER MOUND
State : TX
Zip : 75028-1892
Country : US
Telephone Number : 214-343-6663
Fax Number : 214-343-2814
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2007
Last Update Date : 04/30/2024

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Directions to “ MIA EVANS APRN” Practice Location

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