Provider Demographics
NPI:1891066502
Name:EVANS, ANGEL (LPN)
Entity Type:Individual
Prefix:
First Name:ANGEL
Middle Name:
Last Name:EVANS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 PURCELL ST UNIT J-4
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:CO
Mailing Address - Zip Code:80601-3478
Mailing Address - Country:US
Mailing Address - Phone:303-717-0765
Mailing Address - Fax:
Practice Address - Street 1:2900 PURCELL ST UNIT J-4
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:CO
Practice Address - Zip Code:80601-3478
Practice Address - Country:US
Practice Address - Phone:303-717-0765
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-26
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO38339164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse