Provider Demographics
NPI:1881055754
Name:EVANS, MARIA (APRN)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
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 1:1412 NW VIVION RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64118-4555
Mailing Address - Country:US
Mailing Address - Phone:816-214-5276
Mailing Address - Fax:816-841-4801
Practice Address - Street 1:1412 NW VIVION RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64118-4555
Practice Address - Country:US
Practice Address - Phone:816-214-5276
Practice Address - Fax:816-841-4801
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-18
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016005217363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health