Provider Demographics
NPI:1366085953
Name:EVANS, ASHLEY P
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:P
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 1:231 WOODHAVEN TRL
Mailing Address - Street 2:
Mailing Address - City:MC GREGOR
Mailing Address - State:TX
Mailing Address - Zip Code:76657-4135
Mailing Address - Country:US
Mailing Address - Phone:706-905-9327
Mailing Address - Fax:
Practice Address - Street 1:510 AUSTIN AVE STE 25515
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76701-2117
Practice Address - Country:US
Practice Address - Phone:254-230-4345
Practice Address - Fax:706-243-4254
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-25
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX919501163WP0808X
TX1060086363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental HealthGroup - Single Specialty