Individual
WILLIAM BRANDON EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
1350 HICKORY ST, MELBOURNE, FL 32901-3224
(321) 434-1771
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN11021002
FL
363LF0000X
Family Nurse Practitioner
11021002
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
117774300
—
FL
01
—
QQ856
HFMG MA
FL
Enumeration date
08/28/2021
Last updated
10/09/2023
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