Kelly Lorraine Evans, RN

Primary specialty

Home Health Registered NurseTaxonomy code 163WH0200X

License

495840-1 Issued in NY

Practice address

1540 Glenwood Ave
Syracuse, NY 13207-1011

Phone

(315) 476-1771

NPI assigned

Sep 14, 2008

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1221350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221350400000",
    "number": "1326297482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 RUSKIN AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132071324",
            "telephone_number": "315-479-7983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 GLENWOOD AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132071011",
            "telephone_number": "315-476-1771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "KELLY",
        "middle_name": "LORRAINE",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-14",
        "last_updated": "2008-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "NY",
            "license": "495840-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02701884",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Akilah Evans, MD
• Benjamin Evans
• Brian Keith Evans Jr., CASAC-T
• Heather Evans
• Kayla Evans, LMSW
• Meaghan Evans
• Reese Elizabeth Evans
• Rosemary Evans, NP
• Sandra Gladys Evans, PHARMD
• Melissa Evener, CASAC II

• Home Health Registered Nurse in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Home Health Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.