Provider Demographics
NPI:1376771436
Name:EVANS, DAVID LINN (ARNP-BC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:LINN
Last Name:EVANS
Suffix:
Gender:M
Credentials:ARNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5420 VINEWOOD
Mailing Address - Street 2:
Mailing Address - City:FALLON
Mailing Address - State:NV
Mailing Address - Zip Code:89406-4299
Mailing Address - Country:US
Mailing Address - Phone:775-423-9515
Mailing Address - Fax:781-459-6148
Practice Address - Street 1:5420 VINEWOOD
Practice Address - Street 2:
Practice Address - City:FALLON
Practice Address - State:NV
Practice Address - Zip Code:89406-4299
Practice Address - Country:US
Practice Address - Phone:775-423-9515
Practice Address - Fax:781-459-6148
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-29
Last Update Date:2009-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK553363LP0222X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0222XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics, Critical Care