Evans, Travis Ray

Evans, Travis Ray is an sole proprietor health care provider with primary practice located at 98 Poplar St , Blackfoot ID 83221-1758. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Evans, Travis Ray can be contacted via phone (208) 782-3700.

Contact Information

Primary practice address
98 Poplar St Blackfoot ID 83221-1758
Phone: (208) 782-3700
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X NP-1193A Idaho

Profile Details

NPI number 1861742702
LBN Legal business name Evans, Travis Ray
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 19th, 2012
Last updated Jun 6th, 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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