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Individual

TREVOR JAMES EVANS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1025 NEW MOODY LN, LA GRANGE, KY 40031-9154
(502) 222-5388
Mailing address
10007 SHINING WILLOW DR APT 102, LOUISVILLE, KY 40241-3147
(801) 979-2451

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28237068A
IN
367500000X
Certified Registered Nurse Anesthetist
1166968
KY
367500000X
Certified Registered Nurse Anesthetist
Primary
132048
MT
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300019021
IN
05
7100666370
KY
Enumeration date
04/08/2017
Last updated
10/09/2025
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