Provider Demographics
NPI:1932321718
Name:EVANS-ROMANO, KIRSTEN NOEL (LOTR)
Entity Type:Individual
Prefix:MRS
First Name:KIRSTEN
Middle Name:NOEL
Last Name:EVANS-ROMANO
Suffix:
Gender:F
Credentials:LOTR
Other - Prefix:MRS
Other - First Name:KIRSTEN
Other - Middle Name:NOEL EVANS
Other - Last Name:ROMANO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LOTR
Mailing Address - Street 1:PO BOX 41151
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70835-1151
Mailing Address - Country:US
Mailing Address - Phone:225-819-7360
Mailing Address - Fax:225-769-2441
Practice Address - Street 1:8128 FLORIDA BLVD
Practice Address - Street 2:
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70726-7865
Practice Address - Country:US
Practice Address - Phone:225-791-8666
Practice Address - Fax:225-791-8644
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAZ12161225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist