Dianna K Evans
Individual provider Active NPI Massage Therapist · Fairview, MO
NPI 1801921986 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1801921986
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- Practice address
- 28702 Highway a
Fairview, MO 64842-8160 - Phone
- (417) 652-3768
- NPI assigned
- Feb 22, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 200503838 | MO | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MO | Yes |
Addresses
Primary practice location
28702 Highway a
Fairview, MO 64842-8160
Mailing address
28702 Highway a
Fairview, MO 64842-8160
Phone (417) 652-3768
Other providers in Fairview, MO
All providers in Fairview, MO · Massage Therapist in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.