Provider Demographics
NPI:1760106132
Name:EVANS, KATIE (DNP, APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:EVANS
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1840 CHARLES RD
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44903-9110
Mailing Address - Country:US
Mailing Address - Phone:419-545-1463
Mailing Address - Fax:
Practice Address - Street 1:350 HILLCREST DR
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OH
Practice Address - Zip Code:44805-4052
Practice Address - Country:US
Practice Address - Phone:419-289-9800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-29
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.415639163W00000X
OHAPRN.CNP.0032439363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse