Individual
MS. ANDREA GRACIE EVANS I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
301 UNIVERSITY BLVD DEPT OF PEDS, GALVESTON, TX 77555-0351
(409) 772-1064
Mailing address
301 UNIVERSITY BLVD DEPT OF, GALVESTON, TX 77555-5302
(409) 772-1064
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
884809
TX
363LP0200X
Pediatric Nurse Practitioner
AP08986
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
884809
LICENSE NUMBER
TX
01
—
AP08986
LICENSE NUMBER
LA
01
—
AP131680
LICENSE NUMBER
TX
01
—
RN13082
LICENSE NUMBER
LA
Enumeration date
08/23/2016
Last updated
10/28/2016
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