Provider Demographics
NPI:1386065241
Name:EVANS, LAURA LOVINGGOOD (MSN, NP-C)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:LOVINGGOOD
Last Name:EVANS
Suffix:
Gender:F
Credentials:MSN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1835 SAVOY DR STE 300
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30341-1071
Mailing Address - Country:US
Mailing Address - Phone:770-496-9430
Mailing Address - Fax:404-891-4947
Practice Address - Street 1:1521 HICKORY FLAT HWY STE 100
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30115-3448
Practice Address - Country:US
Practice Address - Phone:770-496-9430
Practice Address - Fax:404-891-4947
Is Sole Proprietor?:No
Enumeration Date:2013-12-19
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN189245363L00000X
CA95000031363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily