Individual
CRISTON B EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDCA
Contact information
Practice address
14532 US HIGHWAY 23, WAVERLY, OH 45690
(740) 285-9624
Mailing address
1529 SWAUGER VALLEY RD, PORTSMOUTH, OH 45662-8898
(740) 285-9624
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
156080
OH
171M00000X
Case Manager/Care Coordinator
CDCA.169327
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0269005
—
OH
Enumeration date
12/14/2017
Last updated
09/19/2019
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