| NPI | 1790930006 |
|---|---|
| Former Name | COLLEEN R EVANS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 144887) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 3704-33) |
| Enumeration Date | 2008-12-01 |
| Last Update Date | 2024-08-27 |