Provider Demographics
NPI:1669894119
Name:EVENS, RACHEL J (APRN, CNM, FNP-C)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:J
Last Name:EVENS
Suffix:
Gender:F
Credentials:APRN, CNM, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1015
Mailing Address - Street 2:
Mailing Address - City:STEVENSVILLE
Mailing Address - State:MT
Mailing Address - Zip Code:59870-1015
Mailing Address - Country:US
Mailing Address - Phone:406-945-5551
Mailing Address - Fax:406-625-2552
Practice Address - Street 1:1220 E POLSTON AVE
Practice Address - Street 2:
Practice Address - City:POST FALLS
Practice Address - State:ID
Practice Address - Zip Code:83854-6056
Practice Address - Country:US
Practice Address - Phone:208-773-1577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-16
Last Update Date:2023-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTNUR-APRN-LIC-100092363LF0000X
MT100092363LX0001X
MTLIC-NUR-RN 33275367A00000X
SDCM000057367A00000X
ID63306363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife