Provider Demographics
NPI:1942985213
Name:EVANS, KELSEY ANNE (CSFA)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:ANNE
Last Name:EVANS
Suffix:
Gender:F
Credentials:CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8042 WURZBACH RD STE 130
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3823
Mailing Address - Country:US
Mailing Address - Phone:210-201-1806
Mailing Address - Fax:
Practice Address - Street 1:8042 WURZBACH RD STE 130
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3823
Practice Address - Country:US
Practice Address - Phone:210-201-2806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-15
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207266246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant