Provider Demographics
NPI:1275552820
Name:EVANS, ANN CATHERINE (MBA, ATC)
Entity Type:Individual
Prefix:MISS
First Name:ANN
Middle Name:CATHERINE
Last Name:EVANS
Suffix:
Gender:F
Credentials:MBA, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:556 HOGE ST
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45226-1107
Mailing Address - Country:US
Mailing Address - Phone:513-532-1774
Mailing Address - Fax:
Practice Address - Street 1:1018 TOWN DRIVE
Practice Address - Street 2:
Practice Address - City:WILDER
Practice Address - State:KY
Practice Address - Zip Code:41076
Practice Address - Country:US
Practice Address - Phone:859-572-0710
Practice Address - Fax:859-572-0716
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2010-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1257174400000X, 2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No174400000XOther Service ProvidersSpecialist