Provider Demographics
NPI:1932500907
Name:EVINS, BILLIE DENISE
Entity Type:Individual
Prefix:
First Name:BILLIE
Middle Name:DENISE
Last Name:EVINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3497 VALERIE ARMS DR
Mailing Address - Street 2:728
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45405-2152
Mailing Address - Country:US
Mailing Address - Phone:937-422-3714
Mailing Address - Fax:
Practice Address - Street 1:3497 VALERIE ARMS DR
Practice Address - Street 2:728
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45405-2152
Practice Address - Country:US
Practice Address - Phone:937-422-3714
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-10
Last Update Date:2014-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
372500000X, 374U00000X
OH401061340310376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No372500000XNursing Service Related ProvidersChore Provider
No376K00000XNursing Service Related ProvidersNurse's Aide