Provider Demographics
NPI:1861202376
Name:EVANS, KAREEN KAYE (APRN)
Entity type:Individual
Prefix:MRS
First Name:KAREEN
Middle Name:KAYE
Last Name:EVANS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:253 GRAND RESERVE DR
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33837-5204
Mailing Address - Country:US
Mailing Address - Phone:407-516-6823
Mailing Address - Fax:407-537-6100
Practice Address - Street 1:253 GRAND RESERVE DR
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33837-5204
Practice Address - Country:US
Practice Address - Phone:407-516-6823
Practice Address - Fax:407-537-6100
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-08
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11036963363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily