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Individual

TINA E EVENSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CFNP

Contact information

Practice address
100 LAKE TRAVERSE DR, SISSETON, SD 57262-7046
(605) 698-7606
Mailing address
439009 NORTHSIDE DR, LAKE CITY, SD 57247-6149

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
2009001820
MN
363LF0000X
Family Nurse Practitioner
Primary
R-130178-2
MN

Other

Enumeration date
05/05/2009
Last updated
03/07/2022
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