Evans, Lori Jo

Evans, Lori Jo is an sole proprietor health care provider with primary practice located at 2005 Mizell Ave Ste 2100 , Winter Park FL 32792-4126. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Evans, Lori Jo can be contacted via phone (407) 599-6460.

Contact Information

Primary practice address
2005 Mizell Ave Ste 2100 Winter Park FL 32792-4126
Phone: (407) 599-6460
Fax: (407) 599-6461
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 50-002502 Ohio
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA9106376 Florida

Profile Details

NPI number 1659453439
LBN Legal business name Evans, Lori Jo
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 20th, 2006
Last updated Mar 22nd, 2022 - about 2 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 1659453439 NPPES
Ohio Other 11907432 CAQH
Ohio MEDICAID 0156040 CAQH

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