Provider Demographics
NPI:1568898674
Name:EVANS, ALICIA MARIE (MSNA, CRNA)
Entity Type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:MARIE
Last Name:EVANS
Suffix:
Gender:F
Credentials:MSNA, CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2504 S STILWELL ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:KS
Mailing Address - Zip Code:66762-6539
Mailing Address - Country:US
Mailing Address - Phone:620-249-6828
Mailing Address - Fax:
Practice Address - Street 1:1 MT CARMEL WAY
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:KS
Practice Address - Zip Code:66762-7587
Practice Address - Country:US
Practice Address - Phone:620-231-6100
Practice Address - Fax:620-231-0081
Is Sole Proprietor?:No
Enumeration Date:2013-09-20
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013035078367500000X
KS557332367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered