Provider Demographics
NPI:1114660248
Name:EVANS, EMILY RACHEL (APRN-CNM)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:RACHEL
Last Name:EVANS
Suffix:
Gender:F
Credentials:APRN-CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25270 MAIDSTONE LN
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-1734
Mailing Address - Country:US
Mailing Address - Phone:216-973-0041
Mailing Address - Fax:
Practice Address - Street 1:9176 WINESBURG RD
Practice Address - Street 2:
Practice Address - City:DUNDEE
Practice Address - State:OH
Practice Address - Zip Code:44624-9437
Practice Address - Country:US
Practice Address - Phone:330-359-0580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-17
Last Update Date:2022-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCNM07481176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife