Provider Demographics
NPI:1376797803
Name:EVANS, NANCY GOEBEL (RNP)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:GOEBEL
Last Name:EVANS
Suffix:
Gender:F
Credentials:RNP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1643 SCENIC LN
Mailing Address - Street 2:
Mailing Address - City:HEALDSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:95448-4535
Mailing Address - Country:US
Mailing Address - Phone:707-433-3587
Mailing Address - Fax:
Practice Address - Street 1:3883 AIRWAY DR STE 165
Practice Address - Street 2:SUITE 3
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95403-1675
Practice Address - Country:US
Practice Address - Phone:707-521-8930
Practice Address - Fax:707-523-1305
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-11
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA296481363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology