Individual
TANYA N EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
1350 HICKORY ST, MELBOURNE, FL 32901-3224
(321) 434-3455
(321) 434-3456
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 434-3455
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
APRN11010617
FL
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN11010617
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113583400
—
FL
01
—
VQ628
MEDICARE HF
FL
Enumeration date
12/14/2020
Last updated
09/12/2025
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