Kathy Evans LLC

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

R543446 Issued in MS

Legal business name

KATHY EVANS LLC

Practice address

210 E Main St
Ste 2B
Tupelo, MS 38804-4017

Phone

(662) 255-0467

Fax

(662) 620-7106

NPI assigned

Oct 5, 2015

Organization subpart

No

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

Authorized official

Name

Ms. Kathy J Evans, PMHNP-BC

Title

Owner

Phone

(662) 620-7102

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1444003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444003200000",
    "number": "1649640400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 E MAIN ST",
            "address_2": "STE 2B",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388044017",
            "telephone_number": "662-255-0467",
            "fax_number": "662-620-7106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 E MAIN ST",
            "address_2": "STE 2B",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388044017",
            "telephone_number": "662-255-0467",
            "fax_number": "662-620-7106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATHY EVANS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-05",
        "last_updated": "2015-10-05",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "KATHY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-620-7102",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MS",
            "license": "R543446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Tupelo, MS
• Psychiatric/Mental Health Registered Nurse in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2015; 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.