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Individual
STACEY D EVANS
Active
Individual
STACEY D EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN,MSN,FNP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
20170
CA
363LG0600X
Gerontology Nurse Practitioner
235025
LA
Other
Enumeration date
09/14/2010
Last updated
05/22/2026
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