Individual
KRISTINE M EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
3905 DOUGLAS AVE, RACINE, WI 53402-3230
(262) 639-5360
Mailing address
16800 WEST CLEVELAND AVE, NEW BERLIN, WI 53151-3533
(262) 432-2005
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2480
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
WI2480
EYEMED VISION NO.
—
Enumeration date
07/28/2006
Last updated
12/21/2007
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