Individual
MS. KATHLEEN KAY EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1200 E MICHIGAN AVE, SUITE 445, LANSING, MI 48912-1800
(517) 364-5210
(517) 364-5216
Mailing address
PO BOX 13008, LANSING, MI 48901-3008
(517) 364-6253
(517) 364-6204
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704149925
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200000002317
PHP PIN #
MI
01
—
5008763770
BCBS INDIVIDUAL PIN
MI
Enumeration date
10/20/2006
Last updated
09/18/2012
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