Provider Demographics
NPI:1528415783
Name:EVANS, YOMEKA M
Entity Type:Individual
Prefix:MRS
First Name:YOMEKA
Middle Name:M
Last Name:EVANS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6237 LA FLEUR DR
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71119-6224
Mailing Address - Country:US
Mailing Address - Phone:318-572-4939
Mailing Address - Fax:
Practice Address - Street 1:4571 N MARKET ST
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71107-2917
Practice Address - Country:US
Practice Address - Phone:318-424-8735
Practice Address - Fax:318-424-8739
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-18
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator