Individual
KELLY A EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
2213 CHERRY ST STE ACC 200, TOLEDO, OH 43608-2603
(419) 251-4283
(419) 251-0814
Mailing address
2200 JEFFERSON AVE, TOLEDO, OH 43604-7101
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
L089241
IA
363LA2100X
Acute Care Nurse Practitioner
4704251383
MI
363LA2100X
Acute Care Nurse Practitioner
Primary
APRN.CNP.022221
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31415
BCBS
IA
Enumeration date
10/21/2005
Last updated
11/05/2019
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