Provider Demographics
NPI:1710326939
Name:EVANS, EMILY LOUISE (MD)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:LOUISE
Last Name:EVANS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1176 TOWN AND COUNTRY COMMONS DR
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-8200
Mailing Address - Country:US
Mailing Address - Phone:636-893-1260
Mailing Address - Fax:636-893-1261
Practice Address - Street 1:1176 TOWN AND COUNTRY COMMONS DR
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017
Practice Address - Country:US
Practice Address - Phone:636-893-1260
Practice Address - Fax:636-893-1261
Is Sole Proprietor?:No
Enumeration Date:2013-06-20
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20170083382084N0400X
MO20130169972084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology