Provider Demographics
NPI:1790939320
Name:EVANS, AMY HEMSTREET (FNP,CNM)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:HEMSTREET
Last Name:EVANS
Suffix:
Gender:F
Credentials:FNP,CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2209 S STERLING ST STE 400
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-4092
Mailing Address - Country:US
Mailing Address - Phone:828-580-4661
Mailing Address - Fax:828-580-4698
Practice Address - Street 1:2209 S STERLING ST STE 400
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-4092
Practice Address - Country:US
Practice Address - Phone:828-580-4661
Practice Address - Fax:828-580-4698
Is Sole Proprietor?:No
Enumeration Date:2008-11-10
Last Update Date:2017-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5000500363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1790939320Medicaid
NC7006007Medicaid
NC7006007Medicaid
NCI45818Medicare UPIN