Provider Demographics
NPI:1831782044
Name:EVANS, LISA ANN (APRN)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:ANN
Last Name:EVANS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2210 GREEN VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-4648
Mailing Address - Country:US
Mailing Address - Phone:812-945-4000
Mailing Address - Fax:
Practice Address - Street 1:2210 GREEN VALLEY RD
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-4648
Practice Address - Country:US
Practice Address - Phone:812-945-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-18
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3014815207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology