Evans, Kathy Jean

Evans, Kathy Jean is an sole proprietor health care provider with primary practice located at 210 E Main St , Tupelo MS 38804-4017. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Evans, Kathy Jean can be contacted via phone (662) 255-0467.

Contact Information

Primary practice address
210 E Main St Tupelo MS 38804-4017
Fax: (662) 620-7106
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X R543446 Mississippi

Profile Details

NPI number 1629016795
LBN Legal business name Evans, Kathy Jean
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 2nd, 2006
Last updated Jun 3rd, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629016795 NPPES
Mississippi MEDICAID 00124239

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