Jackie Denise Evans, RN

Primary specialty

Ambulatory Care Registered NurseTaxonomy code 163WP2201X

License

RN254730 Issued in GA

Practice address

480 Central Ave
Pearl Harbor, HI 96860-4908

Phone

(808) 473-1880

Fax

(808) 473-4449

NPI assigned

Aug 16, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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": "1692144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1720861362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 CENTRAL AVE",
            "city": "PEARL HARBOR",
            "state": "HI",
            "postal_code": "968604908",
            "telephone_number": "808-473-1880",
            "fax_number": "808-473-4449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 CENTRAL AVE",
            "city": "PEARL HARBOR",
            "state": "HI",
            "postal_code": "968604908",
            "telephone_number": "808-473-1880",
            "fax_number": "808-473-4449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "JACKIE",
        "middle_name": "DENISE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-16",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "GA",
            "license": "RN254730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Eller, ARRT(R)(M)(CT)
• Carolyn Howard Ellison, APRN-C
• Tatianna Ellsworth, DNP, FNP-BC, PNP-P
• Lisa Ann English, RN
• Ireneo Espinosa, RN
• Thomas Jay Evans, PH.D.
• Andre M Fang, DDS
• Kenneth Michael Fechner II, MD
• Webster Kerry Felix, DDS, MA, FAGD
• Roberta Lynn Feltes, RN

• Ambulatory Care Registered Nurse in Pearl Harbor, HI
• Providers in Pearl Harbor, HI by specialty
• Ambulatory Care Registered Nurse in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; 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.