Provider Demographics
NPI:1073869210
Name:EVANS, CARLA M (FNP)
Entity Type:Individual
Prefix:MRS
First Name:CARLA
Middle Name:M
Last Name:EVANS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 TURNPIKE AVE
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:RI
Mailing Address - Zip Code:02871-1419
Mailing Address - Country:US
Mailing Address - Phone:401-683-7434
Mailing Address - Fax:401-683-0482
Practice Address - Street 1:79 TURNPIKE AVE
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:RI
Practice Address - Zip Code:02871-1419
Practice Address - Country:US
Practice Address - Phone:401-683-7434
Practice Address - Fax:401-683-0482
Is Sole Proprietor?:No
Enumeration Date:2012-07-25
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRN35540163W00000X
RICAPRN00047363LF0000X
RIAPRN00047363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily