Provider Demographics
NPI:1578652236
Name:EVANS, DARRELL BRIAN SR (CRNA, NP)
Entity Type:Individual
Prefix:MR
First Name:DARRELL
Middle Name:BRIAN
Last Name:EVANS
Suffix:SR
Gender:M
Credentials:CRNA, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6097 MOUNTAIN BROOK RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27455-8384
Mailing Address - Country:US
Mailing Address - Phone:910-485-0065
Mailing Address - Fax:
Practice Address - Street 1:1240 HUFFMAN MILL RD
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-8700
Practice Address - Country:US
Practice Address - Phone:336-538-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC153174363LF0000X, 367500000X
OHAPRN.CRNA.0020116367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily