Most Relevant Information
Provider Data
| NPI Number: | 1003179888 |
| Provider Name: | MARY ANN EVANS RN4 |
| Entity Type: | Individual |
| Taxonomy Code: | 163WC1500X |
| Specialty: | Registered Nurse |
| License Number: | RN066385 |
Most Important Dates
| Enumeration Date: | 06/18/2012 |
| Last Updated: | 06/18/2012 |
Provider Practice Location
1035 CRESWELL AVE
SHREVEPORT
LA
711013917
Practice Location Phone/Fax
| Phone: | 3186765286 |
| Fax: | 3186765221 |
Provider Mailing Location
538 CORRINE PL
WASKOM
TX
756925008
Provider Mailing Phone/Fax
| Phone: | 9036873939 |
| Fax: |