Provider Demographics
NPI:1962657080
Name:EVANS, TAMMY ANN (ARNP)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:ANN
Last Name:EVANS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:1001 SE MONTEREY COMMONS BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34996-3329
Mailing Address - Country:US
Mailing Address - Phone:772-286-9400
Mailing Address - Fax:772-283-3832
Practice Address - Street 1:1001 SE MONTEREY COMMONS BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34996-3329
Practice Address - Country:US
Practice Address - Phone:772-286-9400
Practice Address - Fax:772-283-3832
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-18
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2063972363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLARNP2063972Other006