Provider Demographics
NPI:1013500057
Name:EVANS, JANETT ALCIRA
Entity Type:Individual
Prefix:
First Name:JANETT
Middle Name:ALCIRA
Last Name:EVANS
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 1:8169 CALLE CONCORDIA STE 412
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717-1567
Mailing Address - Country:US
Mailing Address - Phone:787-284-5884
Mailing Address - Fax:
Practice Address - Street 1:8169 CALLE CONCORDIA STE 412
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-1567
Practice Address - Country:US
Practice Address - Phone:787-284-5884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-19
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other