Individual
TARA EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
235 E OHIO AVE, MACCLENNY, FL 32063-2139
(904) 450-3258
Mailing address
235 E OHIO AVE, MACCLENNY, FL 32063-2139
(904) 450-3258
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
PN5236387
FL
Other
Enumeration date
05/15/2026
Last updated
05/15/2026
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