Individual
KATHLEEN NICOLE EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1700 W TOWNLINE ST, CRESTON, IA 50801-1054
(641) 782-7091
(641) 782-3825
Mailing address
1700 W TOWNLINE ST, CRESTON, IA 50801-1054
(641) 782-7091
(641) 782-6425
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
A139952
IA
367500000X
Certified Registered Nurse Anesthetist
Primary
D139952
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1497839252
—
IA
Enumeration date
10/25/2006
Last updated
02/25/2020
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