Provider Demographics
NPI:1669619672
Name:EVANS, LEE OLA (RN)
Entity type:Individual
Prefix:MRS
First Name:LEE
Middle Name:OLA
Last Name:EVANS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:LEE
Other - Middle Name:OLA
Other - Last Name:WILLRICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1814 VAIL CT
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-3759
Mailing Address - Country:US
Mailing Address - Phone:281-835-9083
Mailing Address - Fax:
Practice Address - Street 1:1814 VAIL CT
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-3759
Practice Address - Country:US
Practice Address - Phone:281-835-9083
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-13
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2-24345163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2-24345OtherBOARD OF NURSE EXAMINERS