Provider Demographics
NPI:1922510601
Name:EVANS, NOEL LEE (ATC)
Entity Type:Individual
Prefix:
First Name:NOEL
Middle Name:LEE
Last Name:EVANS
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5709 SAN CRISTEBAL LN
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37921-7614
Mailing Address - Country:US
Mailing Address - Phone:423-201-2237
Mailing Address - Fax:
Practice Address - Street 1:550 TOWN CREEK RD E # 201
Practice Address - Street 2:
Practice Address - City:LENOIR CITY
Practice Address - State:TN
Practice Address - Zip Code:37772-6289
Practice Address - Country:US
Practice Address - Phone:423-201-2237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-02
Last Update Date:2017-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN18912255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer