Individual
MRS. REGINA JONELLE EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
112 W PEELER AVE, SHAW, MS 38773-8710
(662) 754-3301
(662) 754-3304
Mailing address
1722 DAHLIA DR, GREENVILLE, MS 38701-7347
(662) 207-0806
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
903672
MS
Other
Enumeration date
01/08/2020
Last updated
08/20/2020
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