Provider Demographics
NPI:1629190574
Name:EVANS, BARBARA J (ARNP)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:J
Last Name:EVANS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4605 SW 13TH AVE
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33914-6330
Mailing Address - Country:US
Mailing Address - Phone:239-573-5681
Mailing Address - Fax:239-574-0103
Practice Address - Street 1:636 DEL PRADO BLOUEVARD
Practice Address - Street 2:EMPLOYEE HEALTH DEPARTMENT
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990
Practice Address - Country:US
Practice Address - Phone:239-574-0120
Practice Address - Fax:239-574-0103
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1694322282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital