Provider Demographics
NPI:1558120501
Name:DESJARDINS, EVANN (DC)
Entity Type:Individual
Prefix:DR
First Name:EVANN
Middle Name:
Last Name:DESJARDINS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2720 OLD LEBANON PIKE STE 113
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37214-2531
Mailing Address - Country:US
Mailing Address - Phone:615-606-2637
Mailing Address - Fax:
Practice Address - Street 1:2720 OLD LEBANON PIKE STE 113
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37214-2531
Practice Address - Country:US
Practice Address - Phone:615-606-2637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-13
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3630111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor