Provider Demographics
NPI:1881238517
Name:EVANS, CYNTHIA C (FNP-C)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:C
Last Name:EVANS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 W BELLE AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MI
Mailing Address - Zip Code:48655-1611
Mailing Address - Country:US
Mailing Address - Phone:989-865-9958
Mailing Address - Fax:
Practice Address - Street 1:1525 W CARO RD
Practice Address - Street 2:
Practice Address - City:CARO
Practice Address - State:MI
Practice Address - Zip Code:48723-9686
Practice Address - Country:US
Practice Address - Phone:989-860-0088
Practice Address - Fax:989-791-3859
Is Sole Proprietor?:No
Enumeration Date:2019-11-06
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704229785363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily