Provider Demographics
NPI:1659917128
Name:EVANS, JOANN (CRNP)
Entity Type:Individual
Prefix:
First Name:JOANN
Middle Name:
Last Name:EVANS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:JO ANN
Other - Middle Name:
Other - Last Name:EVANS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CRNP
Mailing Address - Street 1:10488 OLDE VILLA DR
Mailing Address - Street 2:
Mailing Address - City:GIBSONIA
Mailing Address - State:PA
Mailing Address - Zip Code:15044-7463
Mailing Address - Country:US
Mailing Address - Phone:570-419-3541
Mailing Address - Fax:
Practice Address - Street 1:4815 LIBERTY AVE STE 160
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-2156
Practice Address - Country:US
Practice Address - Phone:412-578-6808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-20
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP021150363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology