Evans, Marissa
Evans, Marissa is an individual health care provider with primary practice located at 9201 Montgomery Blvd Ne Bldg 5 , Albuquerque NM 87111-2468. She recently has only one registered license in Other Service Providers / Peer Specialist, which is considered as her primary health care specialty. Evans, Marissa can be contacted via phone (505) 217-1717.Contact Information
Primary practice address
9201 Montgomery Blvd Ne Bldg 5
Albuquerque NM 87111-2468
Phone: (505) 217-1717
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Peer Specialist | 175T00000X | 1036 | New Mexico |
Profile Details
| NPI number | 1295367324 |
|---|---|
| LBN Legal business name | Evans, Marissa |
| Credentials | CPSW |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 6th, 2020 |
| Last updated | Feb 6th, 2020 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1295367324 | NPPES |
| New Mexico | Other | 1036 | CERTIFICATE NUMBER |
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