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Individual

EVAN CHARLES DEAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
305 E CENTER AVE, VISALIA, CA 93291-6331
(559) 737-4700
Mailing address
305 E CENTER AVE, VISALIA, CA 93291-6331
(559) 737-4700

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
12135482-8900
UT
363L00000X
Nurse Practitioner
NP95013935
CA
363LF0000X
Family Nurse Practitioner
Primary
95013935
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PENDING
MEDICARE
CA
Enumeration date
02/24/2020
Last updated
12/14/2023
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