Provider Demographics
NPI:1174116354
Name:EVANS, TONIELLE SHYVONNE (LPN)
Entity type:Individual
Prefix:MRS
First Name:TONIELLE
Middle Name:SHYVONNE
Last Name:EVANS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7521 DEER CREEK DR
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30291-1645
Mailing Address - Country:US
Mailing Address - Phone:770-866-6009
Mailing Address - Fax:
Practice Address - Street 1:7521 DEER CREEK DR
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:GA
Practice Address - Zip Code:30291-1645
Practice Address - Country:US
Practice Address - Phone:770-866-6009
Practice Address - Fax:888-524-7084
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-18
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health