Provider Demographics
NPI:1881226512
Name:EVANS, ABBY MARIE (CNP)
Entity Type:Individual
Prefix:
First Name:ABBY
Middle Name:MARIE
Last Name:EVANS
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:ABBY
Other - Middle Name:MARIE
Other - Last Name:ZENNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:5320 W 23RD ST
Mailing Address - Street 2:STE 130
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55416-1670
Mailing Address - Country:US
Mailing Address - Phone:952-345-3213
Mailing Address - Fax:844-593-1082
Practice Address - Street 1:5320 W 23RD ST STE 130
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-1670
Practice Address - Country:US
Practice Address - Phone:952-345-3310
Practice Address - Fax:952-345-8771
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-11
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7227363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology