Provider Demographics
NPI:1285029025
Name:JEAN-PIERRE, EVENS
Entity Type:Individual
Prefix:
First Name:EVENS
Middle Name:
Last Name:JEAN-PIERRE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:EVENS
Other - Middle Name:
Other - Last Name:JEAN-PIERRE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRNA
Mailing Address - Street 1:PO BOX 2974
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-4974
Mailing Address - Country:US
Mailing Address - Phone:803-985-4551
Mailing Address - Fax:803-985-4543
Practice Address - Street 1:222 S HERLONG AVE
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-1158
Practice Address - Country:US
Practice Address - Phone:803-985-4551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-30
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY605346163WC0200X, 367500000X
SC229602367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine