Provider Demographics
NPI:1881226512
Name:EVANS, ABBY MARIE (CNP)
Entity type:Individual
Prefix:
First Name:ABBY
Middle Name:MARIE
Last Name:EVANS
Suffix:
Gender:
Credentials:CNP
Other - Prefix:
Other - First Name:ABBY
Other - Middle Name:MARIE
Other - Last Name:ZENNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:1805 HENNEPIN AVE N
Mailing Address - Street 2:
Mailing Address - City:GLENCOE
Mailing Address - State:MN
Mailing Address - Zip Code:55336-1416
Mailing Address - Country:US
Mailing Address - Phone:320-864-3121
Mailing Address - Fax:320-864-7892
Practice Address - Street 1:1805 HENNEPIN AVE N
Practice Address - Street 2:
Practice Address - City:GLENCOE
Practice Address - State:MN
Practice Address - Zip Code:55336-1416
Practice Address - Country:US
Practice Address - Phone:320-864-3121
Practice Address - Fax:320-864-7892
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-11
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7227363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology