Provider Demographics
NPI:1013286699
Name:EVANS, CHASITY R (CPNP-PC)
Entity Type:Individual
Prefix:MS
First Name:CHASITY
Middle Name:R
Last Name:EVANS
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 W UNIVERSITY AVE
Mailing Address - Street 2:SUITE 404
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47303-3421
Mailing Address - Country:US
Mailing Address - Phone:765-231-9494
Mailing Address - Fax:765-587-4456
Practice Address - Street 1:2525 W UNIVERSITY AVE
Practice Address - Street 2:SUITE 404
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47303-3421
Practice Address - Country:US
Practice Address - Phone:765-231-9494
Practice Address - Fax:765-587-4456
Is Sole Proprietor?:No
Enumeration Date:2011-12-28
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71003791A363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201043570Medicaid
INM400061295Medicare Oscar/Certification