Provider Demographics
NPI:1790212827
Name:SHIELDS, EVAN (OD)
Entity type:Individual
Prefix:DR
First Name:EVAN
Middle Name:
Last Name:SHIELDS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7180 NOLENSVILLE RD STE 1E
Mailing Address - Street 2:
Mailing Address - City:NOLENSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37135-2997
Mailing Address - Country:US
Mailing Address - Phone:615-283-7321
Mailing Address - Fax:615-283-7223
Practice Address - Street 1:7180 NOLENSVILLE RD STE 1E
Practice Address - Street 2:
Practice Address - City:NOLENSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37135-2997
Practice Address - Country:US
Practice Address - Phone:615-283-7321
Practice Address - Fax:615-283-7223
Is Sole Proprietor?:No
Enumeration Date:2017-05-19
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3386152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist