Provider Demographics
NPI:1275151540
Name:EVANS, BRIANA LEIGH
Entity Type:Individual
Prefix:
First Name:BRIANA
Middle Name:LEIGH
Last Name:EVANS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BRIANA
Other - Middle Name:LEIGH
Other - Last Name:OLSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:251 SHIPYARD RD
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-8800
Mailing Address - Country:US
Mailing Address - Phone:912-675-5549
Mailing Address - Fax:
Practice Address - Street 1:340 EISENHOWER DR STE 1200
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-2675
Practice Address - Country:US
Practice Address - Phone:912-443-4200
Practice Address - Fax:912-401-0275
Is Sole Proprietor?:No
Enumeration Date:2020-07-13
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA10019363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical