Individual
LORI M EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 S 18TH AVE, WAUSAU, WI 54401-4252
(715) 842-3084
Mailing address
200 S 18TH AVE, WAUSAU, WI 54401-4252
(715) 842-3084
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5201-33
WI
Other
Enumeration date
01/09/2013
Last updated
07/23/2013
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