Provider Demographics
NPI:1679322903
Name:EVANS, JANICE M
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:M
Last Name:EVANS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7527 BUCHANAN ST APT 249
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20784-6300
Mailing Address - Country:US
Mailing Address - Phone:301-523-7114
Mailing Address - Fax:
Practice Address - Street 1:1164 BLADENSBURG RD NE APT 503
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-2660
Practice Address - Country:US
Practice Address - Phone:912-812-1153
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-17
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant