Provider Information for 1669994828
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KRISTEN EVANS MA
Sex: Female
NPI: 1669994828
Last Updated: 2018-11-29
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1669994828 | ||||||||
| Enumeration Date | 2017-07-10 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 240 N TILLOTSON AVE MUNCIE, IN 47304-3988 United States Phone: 765-254-5184 | Fax:765-741-0335 | ||||||||
| Primary Practice Address | 2010 BRENTWOOD DR ANDERSON, IN 46011-4042 United States Phone: 765-393-0063 | Fax:765-393-3761 | ||||||||
| Secondary Practice Address(es) | 3620 W WHITE RIVER BLVD | ||||||||
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