Individual
PHYLLIS A. EVETTS
Active
Individual
PHYLLIS A. EVETTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N., ANP, CNS
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
226922
TX
364S00000X
Clinical Nurse Specialist
226922
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
153941301
—
TX
01
—
500027727
RR MEDICARE
TX
01
—
8N2972
BCBS
TX
Enumeration date
11/20/2006
Last updated
05/31/2011
Update your record
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