Individual
CALVIN CALEB EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
902 GALLIA ST, PORTSMOUTH, OH 45662-4139
(740) 529-2125
Mailing address
PO BOX 3095, DUBLIN, OH 43016-0046
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN.327283
OH
363LF0000X
Family Nurse Practitioner
Primary
COA.15131-NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0096547
—
OH
01
—
7100317750
KENTUCKY MEDICAID
KY
Enumeration date
09/16/2013
Last updated
09/26/2025
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