Individual
KENDRA NICOLE EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
4123 DUTCHMANS LN STE 102, LOUISVILLE, KY 40207-4718
(502) 559-1670
(502) 394-1999
Mailing address
PO BOX 776879, CHICAGO, IL 60677-6879
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
3009705
KY
363LF0000X
Family Nurse Practitioner
Primary
3009705
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300010306
—
IN
05
—
7100384710
—
KY
01
—
K184391
MEDICARE
KY
Enumeration date
09/14/2015
Last updated
08/03/2022
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