Provider Demographics
NPI:1568492486
Name:EVANS, VIVIENNE ANN (ARNP)
Entity type:Individual
Prefix:
First Name:VIVIENNE
Middle Name:ANN
Last Name:EVANS
Suffix:
Gender:
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 NW 11TH ST STE E37
Mailing Address - Street 2:
Mailing Address - City:HERMISTON
Mailing Address - State:OR
Mailing Address - Zip Code:97838-8604
Mailing Address - Country:US
Mailing Address - Phone:541-567-5305
Mailing Address - Fax:541-667-3831
Practice Address - Street 1:600 NW 11TH ST STE E37
Practice Address - Street 2:
Practice Address - City:HERMISTON
Practice Address - State:OR
Practice Address - Zip Code:97838-8604
Practice Address - Country:US
Practice Address - Phone:541-567-5305
Practice Address - Fax:541-667-3831
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR202211544NP-PP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1568492486OtherNPI
FLP59707Medicare UPIN
FL1568492486OtherNPI