Provider Demographics
NPI:1477812568
Name:EVANS, SELINA (APRN/ANP)
Entity Type:Individual
Prefix:MRS
First Name:SELINA
Middle Name:
Last Name:EVANS
Suffix:
Gender:F
Credentials:APRN/ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 ROSE AVE
Mailing Address - Street 2:BUILDING 1
Mailing Address - City:DEL RIO
Mailing Address - State:TX
Mailing Address - Zip Code:78840-7659
Mailing Address - Country:US
Mailing Address - Phone:210-364-3334
Mailing Address - Fax:
Practice Address - Street 1:612 N BEDELL AVE
Practice Address - Street 2:SUITE A
Practice Address - City:DEL RIO
Practice Address - State:TX
Practice Address - Zip Code:78840-3927
Practice Address - Country:US
Practice Address - Phone:830-774-1166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-09
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX730883363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health