Provider Demographics
NPI:1285387555
Name:EVANS, KENDRA NICHOLE (FNP)
Entity type:Individual
Prefix:
First Name:KENDRA
Middle Name:NICHOLE
Last Name:EVANS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 JORDAN LN
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-8913
Mailing Address - Country:US
Mailing Address - Phone:256-627-1460
Mailing Address - Fax:
Practice Address - Street 1:1100 S JACKSON HWY STE 100
Practice Address - Street 2:
Practice Address - City:SHEFFIELD
Practice Address - State:AL
Practice Address - Zip Code:35660-5769
Practice Address - Country:US
Practice Address - Phone:256-314-2550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-27
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-162244163WE0003X
ALF08211085363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WE0003XNursing Service ProvidersRegistered NurseEmergency