Provider Demographics
NPI:1174818561
Name:EVANS, KAREN S
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:S
Last Name:EVANS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 W BROADWAY ST
Mailing Address - Street 2:P O BOX 248
Mailing Address - City:EXCELSIOR SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64024-2102
Mailing Address - Country:US
Mailing Address - Phone:816-630-9290
Mailing Address - Fax:816-630-9207
Practice Address - Street 1:300 W BROADWAY ST
Practice Address - Street 2:
Practice Address - City:EXCELSIOR SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64024-2102
Practice Address - Country:US
Practice Address - Phone:816-630-9290
Practice Address - Fax:816-630-9207
Is Sole Proprietor?:No
Enumeration Date:2011-06-14
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist