Provider Demographics
NPI:1275327587
Name:EVANS, TINA M (EDD)
Entity type:Individual
Prefix:DR
First Name:TINA
Middle Name:M
Last Name:EVANS
Suffix:
Gender:
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33023 HARVEST DR
Mailing Address - Street 2:
Mailing Address - City:CARRSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23315-2123
Mailing Address - Country:US
Mailing Address - Phone:757-641-4832
Mailing Address - Fax:
Practice Address - Street 1:33023 HARVEST DR
Practice Address - Street 2:
Practice Address - City:CARRSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23315-2123
Practice Address - Country:US
Practice Address - Phone:757-641-4832
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-09
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care