Provider Demographics
NPI:1750881116
Name:EVANS-GEORGE, MHYKEISHA (NP)
Entity type:Individual
Prefix:MRS
First Name:MHYKEISHA
Middle Name:
Last Name:EVANS-GEORGE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 TIMBERLAND RIDGE BLVD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70507-2746
Mailing Address - Country:US
Mailing Address - Phone:318-458-4523
Mailing Address - Fax:
Practice Address - Street 1:155 ODD FELLOWS RD
Practice Address - Street 2:
Practice Address - City:CROWLEY
Practice Address - State:LA
Practice Address - Zip Code:70526-2204
Practice Address - Country:US
Practice Address - Phone:337-514-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-12
Last Update Date:2018-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAF01180392363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily