Provider Demographics
NPI:1770303547
Name:EVANS, KADESHA CLARK (PMHNP-BC)
Entity type:Individual
Prefix:DR
First Name:KADESHA
Middle Name:CLARK
Last Name:EVANS
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1566 S GILBERT ST UNIT 1023
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240-4304
Mailing Address - Country:US
Mailing Address - Phone:319-853-8378
Mailing Address - Fax:319-253-3915
Practice Address - Street 1:1566 S GILBERT ST UNIT 1023
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-4304
Practice Address - Country:US
Practice Address - Phone:319-853-8378
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-15
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAG182509363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty