Individual
JEAN EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
STNA
Contact information
Practice address
110 N HARRISON RD, DONNELSVILLE, OH 45319-5018
(937) 369-8481
Mailing address
PO BOX 103, DONNELSVILLE, OH 45319-0103
(937) 369-8481
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2101693
—
OH
Enumeration date
09/03/2014
Last updated
09/03/2014
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