Provider Demographics
NPI:1730364431
Name:EVANS, NANCY G (PT MS)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:G
Last Name:EVANS
Suffix:
Gender:F
Credentials:PT MS
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Mailing Address - Street 1:PO BOX 40696
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-0696
Mailing Address - Country:US
Mailing Address - Phone:317-506-6341
Mailing Address - Fax:317-566-8270
Practice Address - Street 1:7508 HARTINGTON PL
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46259-5819
Practice Address - Country:US
Practice Address - Phone:317-506-6341
Practice Address - Fax:317-566-8270
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-01
Last Update Date:2008-01-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN0500802A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist