Individual
KELLY EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
85 HIGHWAY 80, MANCHESTER, KY 40962-8801
(606) 596-0410
(606) 528-8272
Mailing address
1019 CUMBERLAND FALLS HWY, SUITE B201, CORBIN, KY 40701-2735
(606) 526-9005
(606) 526-8606
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
02584
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64012206
—
KY
Enumeration date
11/03/2006
Last updated
01/17/2019
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