Provider Demographics
NPI:1396276572
Name:EVANS, CAROLE (NP)
Entity type:Individual
Prefix:
First Name:CAROLE
Middle Name:
Last Name:EVANS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10999 REED HARTMAN HWY
Mailing Address - Street 2:STE 215
Mailing Address - City:BLUE ASH
Mailing Address - State:OH
Mailing Address - Zip Code:45242-8331
Mailing Address - Country:US
Mailing Address - Phone:513-745-9320
Mailing Address - Fax:
Practice Address - Street 1:10999 REED HARTMAN HWY
Practice Address - Street 2:STE 215
Practice Address - City:BLUE ASH
Practice Address - State:OH
Practice Address - Zip Code:45242-8331
Practice Address - Country:US
Practice Address - Phone:513-745-9320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-21
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.020606363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner