Provider Demographics
NPI:1083945653
Name:EVANS, CARLA M (FNP)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:M
Last Name:EVANS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:990 SONOMA AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95404-4813
Mailing Address - Country:US
Mailing Address - Phone:707-527-8444
Mailing Address - Fax:707-527-1071
Practice Address - Street 1:990 SONOMA AVE STE 2
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95404-4813
Practice Address - Country:US
Practice Address - Phone:707-527-8444
Practice Address - Fax:707-527-5327
Is Sole Proprietor?:No
Enumeration Date:2010-01-21
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA19230363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner