Individual
KYLE PRESTON EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
6435 W JEFFERSON BLVD # 434, FORT WAYNE, IN 46804-6203
(260) 436-7875
(260) 432-9812
Mailing address
PO BOX 843603, DALLAS, TX 75284-3603
(972) 233-1999
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN706204
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
28287986A
IN
Other
Enumeration date
09/14/2024
Last updated
12/16/2024
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