Provider Demographics
NPI:1750746210
Name:EVANS, LACHELLE (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:LACHELLE
Middle Name:
Last Name:EVANS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MRS
Other - First Name:LACHELLE
Other - Middle Name:
Other - Last Name:BLUNT-EVANS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:120 WOODLAKE TER
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-2039
Mailing Address - Country:US
Mailing Address - Phone:757-799-0992
Mailing Address - Fax:
Practice Address - Street 1:120 WOODLAKE TER
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-2039
Practice Address - Country:US
Practice Address - Phone:757-409-0410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-28
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024173137363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily