Individual
MS. TONI-TAILA EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
805 N WHITTINGTON PKWY, LOUISVILLE, KY 40222-7101
(904) 238-2537
Mailing address
174 LACONIA ST, SPRINGFIELD, MA 01129-1111
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LN99414
MA
Other
Enumeration date
09/24/2024
Last updated
09/24/2024
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