Provider Demographics
NPI:1609806066
Name:EVANS, CYNTHIA N (CRNP)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:N
Last Name:EVANS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 MARTLING RD
Mailing Address - Street 2:
Mailing Address - City:ALBERTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35951-7209
Mailing Address - Country:US
Mailing Address - Phone:256-660-5560
Mailing Address - Fax:256-660-5564
Practice Address - Street 1:415 MARTLING RD
Practice Address - Street 2:
Practice Address - City:ALBERTVILLE
Practice Address - State:AL
Practice Address - Zip Code:35951-7209
Practice Address - Country:US
Practice Address - Phone:256-660-5560
Practice Address - Fax:256-660-5564
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2018-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1023585363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL5101500403Medicare PIN