Provider Demographics
NPI:1710525027
Name:EVANS, RICEEHA
Entity Type:Individual
Prefix:
First Name:RICEEHA
Middle Name:
Last Name:EVANS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 MEADOW CT UNIT 505
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50320-4626
Mailing Address - Country:US
Mailing Address - Phone:515-723-1190
Mailing Address - Fax:
Practice Address - Street 1:2000 MEADOW CT UNIT 505
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50320-4626
Practice Address - Country:US
Practice Address - Phone:515-723-1190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-17
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide