Provider Demographics
NPI:1568019958
Name:EVANS, JOHANNA DEE (FNP-C, APRN)
Entity type:Individual
Prefix:
First Name:JOHANNA
Middle Name:DEE
Last Name:EVANS
Suffix:
Gender:F
Credentials:FNP-C, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:746 COUNTY ROAD 75
Mailing Address - Street 2:
Mailing Address - City:BISHOP
Mailing Address - State:TX
Mailing Address - Zip Code:78343-9702
Mailing Address - Country:US
Mailing Address - Phone:361-445-7673
Mailing Address - Fax:
Practice Address - Street 1:746 COUNTY ROAD 75
Practice Address - Street 2:
Practice Address - City:BISHOP
Practice Address - State:TX
Practice Address - Zip Code:78343-9702
Practice Address - Country:US
Practice Address - Phone:361-445-7673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-21
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP142649363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily