Provider Demographics
NPI:1982401709
Name:EVANS, DAVID
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:EVANS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16730 ALLORA CT UNIT 118
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:NE
Mailing Address - Zip Code:68028-5580
Mailing Address - Country:US
Mailing Address - Phone:661-972-0308
Mailing Address - Fax:
Practice Address - Street 1:16730 ALLORA CT UNIT 118
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:NE
Practice Address - Zip Code:68028-5580
Practice Address - Country:US
Practice Address - Phone:661-972-0308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-27
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care