Provider Demographics
NPI:1962365924
Name:EVANS, ANNALEE JOELL
Entity type:Individual
Prefix:
First Name:ANNALEE
Middle Name:JOELL
Last Name:EVANS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14345 CHUKAR ST
Mailing Address - Street 2:
Mailing Address - City:CALDWELL
Mailing Address - State:ID
Mailing Address - Zip Code:83607-7738
Mailing Address - Country:US
Mailing Address - Phone:541-861-9014
Mailing Address - Fax:541-861-9014
Practice Address - Street 1:14345 CHUKAR ST
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:ID
Practice Address - Zip Code:83607-7738
Practice Address - Country:US
Practice Address - Phone:541-861-9014
Practice Address - Fax:541-861-9014
Is Sole Proprietor?:Yes
Enumeration Date:2025-12-06
Last Update Date:2025-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife