Individual
TERESA CLAIRE EVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1515 W FIR ST, PORTALES, NM 88130-5703
(575) 356-6695
(575) 356-5948
Mailing address
1515 W FIR ST, PORTALES, NM 88130-5703
(575) 359-3820
(575) 346-5948
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
53252
NM
363LF0000X
Family Nurse Practitioner
AP126422
TX
Other
Enumeration date
10/14/2014
Last updated
11/01/2018
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