Provider Demographics
NPI:1437855533
Name:EVANS, KRISTIN (FNP-C)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:EVANS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:PIERCE CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65723-1112
Mailing Address - Country:US
Mailing Address - Phone:417-489-7868
Mailing Address - Fax:
Practice Address - Street 1:205 N ELM ST
Practice Address - Street 2:
Practice Address - City:PIERCE CITY
Practice Address - State:MO
Practice Address - Zip Code:65723-1112
Practice Address - Country:US
Practice Address - Phone:417-489-7868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-01
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOF01231489363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily