Provider Demographics
NPI:1851557268
Name:EVANS, AMY ALICIA (RN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:ALICIA
Last Name:EVANS
Suffix:
Gender:F
Credentials:RN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 A WEST MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SMITHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37166-1142
Mailing Address - Country:US
Mailing Address - Phone:615-597-8731
Mailing Address - Fax:615-597-7300
Practice Address - Street 1:516 A WEST MAIN ST
Practice Address - Street 2:
Practice Address - City:SMITHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37166-1142
Practice Address - Country:US
Practice Address - Phone:615-597-8731
Practice Address - Fax:615-597-7300
Is Sole Proprietor?:No
Enumeration Date:2008-08-05
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN13568363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily