Provider Demographics
NPI:1851783336
Name:EVANS, LORENA S (NP-C)
Entity Type:Individual
Prefix:
First Name:LORENA
Middle Name:S
Last Name:EVANS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8874 N SKY DANCER CIR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85742-8489
Mailing Address - Country:US
Mailing Address - Phone:520-425-6634
Mailing Address - Fax:
Practice Address - Street 1:3870 W RIVER RD STE 126
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741-3080
Practice Address - Country:US
Practice Address - Phone:520-219-6616
Practice Address - Fax:520-742-6187
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-20
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP7578146D00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant