Individual
MRS. AMY ELIZABETH EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1168 CHERRY LANE RD, GLADE VALLEY, NC 28627-9281
(336) 467-4357
Mailing address
1168 CHERRY LANE RD, GLADE VALLEY, NC 28627-9281
(336) 467-4357
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3827
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1175F
BCBS/NC
NC
01
—
162834
HUMANA
NC
01
—
173442
ANTHEM OF VIRGINIA
NC
01
—
2211795
FIRST HEALTH
NC
05
—
7301562
—
NC
01
—
A9496
MEDCOST PREFERRED
NC
Enumeration date
10/26/2005
Last updated
06/04/2020
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