Most Relevant Information
Provider Data
| NPI Number: | 1003445115 |
| Provider Name: | BLAKE EVANS |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/02/2020 |
| Last Updated: | 04/06/2020 |
Provider Practice Location
3901 RAINBOW BLVD
KANSAS CITY
KS
661608500
Practice Location Phone/Fax
| Phone: | 9139457483 |
| Fax: |
Provider Mailing Location
3901 RAINBOW BLVD
MAIL STOP 1034
KANSAS CITY
KS
66160
Provider Mailing Phone/Fax
| Phone: | 9135883302 |
| Fax: | 9135883365 |