Provider Demographics
NPI:1164671137
Name:EVANS, CHERRIE (FNP-C, APRN)
Entity Type:Individual
Prefix:
First Name:CHERRIE
Middle Name:
Last Name:EVANS
Suffix:
Gender:F
Credentials:FNP-C, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 127
Mailing Address - Street 2:
Mailing Address - City:ROCK POINT
Mailing Address - State:AZ
Mailing Address - Zip Code:86545-0127
Mailing Address - Country:US
Mailing Address - Phone:928-659-4116
Mailing Address - Fax:928-659-4115
Practice Address - Street 1:ONE MISSION LANE
Practice Address - Street 2:STE. 1 NAVAJO MISSION
Practice Address - City:ROCK POINT
Practice Address - State:AZ
Practice Address - Zip Code:86545
Practice Address - Country:US
Practice Address - Phone:928-659-4116
Practice Address - Fax:928-659-4115
Is Sole Proprietor?:No
Enumeration Date:2008-09-15
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT220449-8900363LF0000X
AZAP3264363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily