Individual
MICHELLE ERIN EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
415 E COOK RD STE 300, FORT WAYNE, IN 46825-3657
(317) 948-7208
(317) 944-5791
Mailing address
PO BOX 713577, CHICAGO, IL 60677-0403
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
28151551A
IN
363LP0200X
Pediatric Nurse Practitioner
Primary
71015413A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300092634
—
IN
Enumeration date
07/31/2023
Last updated
02/26/2026
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