Provider Demographics
NPI:1518137892
Name:EVANS, PAMELA (MSN,FNP)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:
Last Name:EVANS
Suffix:
Gender:F
Credentials:MSN,FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:FARMVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23909-1800
Mailing Address - Country:US
Mailing Address - Phone:434-395-2402
Mailing Address - Fax:
Practice Address - Street 1:201 HIGH ST
Practice Address - Street 2:
Practice Address - City:FARMVILLE
Practice Address - State:VA
Practice Address - Zip Code:23909-1800
Practice Address - Country:US
Practice Address - Phone:434-395-2402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-03
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024059375363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily