Individual
JENNIFER EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
613 FRANKLIN ST STE C, MICHIGAN CITY, IN 46360-3411
(317) 449-9669
(888) 915-0644
Mailing address
613 FRANKLIN ST STE C, MICHIGAN CITY, IN 46360-3411
(317) 449-9669
(888) 915-0644
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28145112A
IN
363LF0000X
Family Nurse Practitioner
71003874A
IN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
71003874A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201067810
—
IN
Enumeration date
12/29/2011
Last updated
04/16/2023
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