Individual
KATRINA L EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1251 WOODS ST, JACKSONVILLE, FL 32209-7136
(904) 651-0614
(904) 354-0741
Mailing address
1251 WOODS ST, JACKSONVILLE, FL 32209-7136
(904) 651-0614
(904) 354-0741
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
006259100
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006259100
—
FL
Enumeration date
09/26/2019
Last updated
09/26/2019
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