Provider Demographics
NPI:1083845705
Name:EVANS, JASON ERIC (APN)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:ERIC
Last Name:EVANS
Suffix:
Gender:M
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 PRINGLE WAY STE 705
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-1472
Mailing Address - Country:US
Mailing Address - Phone:775-329-0333
Mailing Address - Fax:775-329-6954
Practice Address - Street 1:75 PRINGLE WAY STE 705
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1472
Practice Address - Country:US
Practice Address - Phone:775-329-0333
Practice Address - Fax:775-329-6954
Is Sole Proprietor?:No
Enumeration Date:2009-07-29
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN47620363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner