Provider Demographics
NPI:1639261266
Name:EVANS, JUDITH (CPNP)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:
Last Name:EVANS
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:JUDITH
Other - Middle Name:
Other - Last Name:ZIEHL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPNP
Mailing Address - Street 1:9900 INDEPENDENCE PARK DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23233-1473
Mailing Address - Country:US
Mailing Address - Phone:804-747-1855
Mailing Address - Fax:804-762-8837
Practice Address - Street 1:7347 BELL CREEK RD
Practice Address - Street 2:SUITE 100
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23111-3504
Practice Address - Country:US
Practice Address - Phone:804-559-0447
Practice Address - Fax:804-559-2037
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024087685363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics