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Individual

SUE EVANS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
317 IRENE AVE, IRONTON, MN 56455
(218) 546-6242
(218) 772-0326
Mailing address
317 IRENE AVE., P.O. BOX 1, IRONTON, MN 56455
(218) 546-6242
(218) 772-0326

Taxonomy

Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
1965021
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1124458005
MN
05
1669628921
MN
Enumeration date
05/25/2021
Last updated
05/25/2021
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