Individual
EVANS NEXSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
800 E HIGH ST, CHARLOTTESVILLE, VA 22902-5126
(901) 230-1536
Mailing address
2530 PINE LN, CHARLOTTESVILLE, VA 22901-5017
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
390200000X
390200000X
—
Enumeration date
06/26/2022
Last updated
06/26/2022
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