Individual
DR. KAREN S EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5110 N CLINTON ST, FORT WAYNE, IN 46825-5720
(260) 469-6605
(260) 969-3066
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01035240A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000111034
ANTHEM GROUP NUMBER
IN
05
—
100081140
—
IN
01
—
7539045
AETNA PIN
IN
Enumeration date
11/03/2005
Last updated
10/14/2022
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