Individual
MS. CASSANDRA EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.P.N.
Contact information
Practice address
3988 MAPLELEAF DR, DAYTON, OH 45416-1946
(937) 723-7647
Mailing address
PO BOX 60873, DAYTON, OH 45406-0873
(937) 723-7647
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
073542
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16
NURSING
OH
Enumeration date
10/15/2007
Last updated
10/15/2007
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