Individual
BARON C EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
427 EMERALD TRL, BRANDON, MS 39047-6513
(601) 757-7306
Mailing address
427 EMERALD TRL, BRANDON, MS 39047-6513
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
326775
MS
Other
Enumeration date
11/01/2023
Last updated
11/01/2023
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