Provider Demographics
NPI:1083737308
Name:EVANS, ANNEMARIE (ED D)
Entity Type:Individual
Prefix:DR
First Name:ANNEMARIE
Middle Name:
Last Name:EVANS
Suffix:
Gender:F
Credentials:ED D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:468 HARBOUR VIEW DR
Mailing Address - Street 2:
Mailing Address - City:KILL DEVIL HILLS
Mailing Address - State:NC
Mailing Address - Zip Code:27948-9133
Mailing Address - Country:US
Mailing Address - Phone:252-715-1346
Mailing Address - Fax:
Practice Address - Street 1:2510 S CROATAN HWY
Practice Address - Street 2:SUITE E
Practice Address - City:NAGS HEAD
Practice Address - State:NC
Practice Address - Zip Code:27959-9016
Practice Address - Country:US
Practice Address - Phone:252-715-1346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1945103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical