Provider Demographics
NPI:1386891356
Name:EVANS, KIMBERLY RICE (APN)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:RICE
Last Name:EVANS
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9330 PARKWEST BLVD
Mailing Address - Street 2:STE 302
Mailing Address - City:KNXOVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923
Mailing Address - Country:US
Mailing Address - Phone:865-531-5878
Mailing Address - Fax:865-531-7690
Practice Address - Street 1:9330 PARKWEST BLVD
Practice Address - Street 2:STE 302
Practice Address - City:KNXOVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4311
Practice Address - Country:US
Practice Address - Phone:865-531-5878
Practice Address - Fax:865-531-7690
Is Sole Proprietor?:No
Enumeration Date:2008-08-21
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000118561363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner