Individual
MS. ETTA EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
1515 NE LAWRIE TATUM RD, LAWTON, OK 73507-3002
(580) 354-5000
Mailing address
1515 NE LAWRIE TATUM RD, LAWTON, OK 73507-3002
(580) 354-5000
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
238764
TX
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
238764
TX
Other
Enumeration date
06/29/2012
Last updated
12/19/2018
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