Individual
KATHY JEAN EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
210 E MAIN ST, TUPELO, MS 38804-4017
(662) 255-0467
(662) 620-7106
Mailing address
210 E MAIN ST, STE B, TUPELO, MS 38804-4017
(662) 255-0467
(662) 620-7106
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R543446
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00124239
—
MS
Enumeration date
06/02/2006
Last updated
06/03/2015
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