Provider Demographics
NPI:1457526253
Name:EVANS, DANA JEAN (LPN)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:JEAN
Last Name:EVANS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2856 PICKERINGTON RD
Mailing Address - Street 2:
Mailing Address - City:CARROLL
Mailing Address - State:OH
Mailing Address - Zip Code:43112-9749
Mailing Address - Country:US
Mailing Address - Phone:740-974-6533
Mailing Address - Fax:
Practice Address - Street 1:2856 PICKERINGTON RD
Practice Address - Street 2:
Practice Address - City:CARROLL
Practice Address - State:OH
Practice Address - Zip Code:43112-9749
Practice Address - Country:US
Practice Address - Phone:740-974-6533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-23
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN120540164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse