Individual
DEAYRIE BONITA EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
6228 S 54TH LN, LAVEEN, AZ 85339-9639
(602) 317-7427
Mailing address
6228 S 54TH LN, LAVEEN, AZ 85339-9639
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
133069
AZ
363LF0000X
Family Nurse Practitioner
Primary
TAP10919
AZ
Other
Enumeration date
01/23/2018
Last updated
01/24/2018
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