Individual
MS. KIMBERLY A EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3707 BRAMBLETON AVE SW, SUITE 2, ROANOKE, VA 24018
(540) 725-7800
Mailing address
3707 BRAMBLETON AVE SW, SUITE 2, ROANOKE, VA 24018
(540) 725-7800
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110001738
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1952380859
—
VA
05
—
QMB1952380859
—
VA
Enumeration date
01/10/2006
Last updated
10/27/2008
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