MS. ETTA EVANS (NPI# 1073877460) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073877460 |
| Entity Type | Individual |
| Full Name | MS. ETTA EVANS |
| Credential | NURSE PRACTITIONER |
| Practice Address |
1515 Ne Lawrie Tatum Rd Lawton OK 73507-3002 |
| Practice Telephone | 5803545000 |
| Mailing Telephone | 5803545000 |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2018-12-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
238764 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LX0001X |
Nurse Practitioner Specialization: Obstetrics & Gynecology |
238764 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4715 View Ridge Ave., Suite 230, San Diego, CA 92123 | 8002578715 |
| Street Address |
1515 NE LAWRIE TATUM RD |
| City | LAWTON |
| State | OK |
| Zip Code | 73507-3002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710982160 | Greg Alan Ketcher | Optometrist | 1515 Ne Lawrie Tatum Rd, Lawton, OK 73507-3002 | 2005-06-14 |
| 1295332765 | Dean Thompson | Case Manager/Care Coordinator | 1515 Ne Lawrie Tatum Rd, Lawton, OK 73507-3099 | 2020-10-07 |
| 1447863832 | Susan Browning | Registered Nurse | 1515 Ne Lawrie Tatum Rd, Lawton, OK 73507-3099 | 2020-08-26 |
| 1144831983 | Christopher Anthony | Radiologic Technologist | 1515 Ne Lawrie Tatum Rd, Lawton, OK 73507-3099 | 2020-08-14 |
| 1851914782 | Emily Jean Mcintosh | Registered Nurse | 1515 Ne Lawrie Tatum Rd, Lawton, OK 73507-3099 | 2020-05-27 |
| 1215559828 | Miaka Huynh | Pharmacist | 1515 Ne Lawrie Tatum Rd, Lawton, OK 73507-3099 | 2020-05-18 |
| 1568084671 | Janet Laura Tippeconnic | Technician, Other | 1515 Ne Lawrie Tatum Rd, Lawton, OK 73507-3099 | 2020-05-12 |
| 1598387698 | Edward Jerome Tahhahwah IIi | Technician, Other | 1515 Ne Lawrie Tatum Rd, Lawton, OK 73507-3099 | 2020-05-12 |
| 1861014961 | Amber Karty | Technician, Other | 1515 Ne Lawrie Tatum Rd, Lawton, OK 73507-3099 | 2020-05-12 |
| 1689293227 | Stephanie Young | Registered Nurse | 1515 Ne Lawrie Tatum Rd, Lawton, OK 73507-3099 | 2020-04-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720619935 | Kori Wren Wiegmann | Registered Nurse | 1515 Nw Lawrie Tatum Road, Lawton, OK 73507 | 2020-01-28 |
| 1013424027 | Liane Jacobson | Registered Nurse | 1515 Laurie Tatum Road, Adult Care Clinic 2, Lawton, OK 73507 | 2017-12-29 |
| 1649727041 | Rachel Ayala | Dietitian, Registered | 2811 Nw Hilltop Dr, Lawton, OK 73507 | 2016-09-02 |
| 1811370471 | William S, Davies, M.d., Inc. | Psychiatric Residential Treatment Facility | 1302 N, W, Lake Ave, Lawton, OK 73507 | 2015-07-01 |
| 1538554894 | Ashlee A Haugen-lewis | Behavioral Analyst | 4121 W Gore, Lawton, OK 73507 | 2015-04-03 |
| 1003188970 | Jenny Rae Mohon | Registered Nurse | 1515 North East Lawrie Tatum Road, Usphs Lawton Indian Hospital, Lawton, OK 73507 | 2012-02-07 |
| 1558548578 | Dawn M Griffith | Registered Nurse | 1515 Lawrie Tatum Dr., Lawton, OK 73507 | 2008-01-22 |
| 1275605172 | Judy Weiss | Pharmacist | 524 Lawrie Tatum Rd, Lawton, OK 73507 | 2006-11-15 |
| 1790895894 | William Spalding Davies | Psychiatry & Neurology | 1302 Lake Ave, Lawton, OK 73507 | 2006-08-30 |
| 1275646374 | Phillip Lynn Aday | Dentist | 1116 Nw Arlington, Lawton, OK 73507 | 2006-08-16 |
| Find all providers in zip 73507 | ||||
| Taxonomy Code | 363LX0001X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Obstetrics & Gynecology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306831979 | Constance Ann Davis | Nurse Practitioner | 102 Nw 31st St, Lawton, OK 73505-6100 | 2005-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891294419 | Meredith Anne Dewitte | Nurse Practitioner | 2115 Duncan Regional Loop Ste 100, Duncan, OK 73533-1570 | 2018-02-09 |
| 1841581519 | Ashley Nicole Willeford | Nurse Practitioner | 105 S. Bryant Ave, #304, Edmond, OK 73034-6331 | 2011-04-28 |
| 1437223484 | Kathryne Lucille Erwin | Nurse Practitioner | 912 S College Ave, Tahlequah, OK 74464-4726 | 2006-11-20 |
| 1730270463 | Catherine Williams Gardner | Nurse Practitioner | 1101 N Bryant Avenue, Edmond, OK 73034-3251 | 2006-09-27 |
| 1225031081 | Cynthia A Bigheart | Nurse Practitioner | 316 W Owen K Garriott Rd, Enid, OK 73701-5622 | 2005-05-24 |
| 1710530688 | Jessica Klingeman | Nurse Practitioner | 1124 S Braden Ave, Tulsa, OK 74112-5331 | 2019-07-19 |
| 1578027876 | Jennie Nicole Garrod | Nurse Practitioner | 3300 Nw 56th St, Oklahoma City, OK 73112-4538 | 2019-01-31 |
| 1043742364 | Lori Deeann Price | Nurse Practitioner | 1200 Childrens Ave, Oklahoma City, OK 73104-4637 | 2017-03-28 |
| 1740737121 | Jenna Aizenman | Nurse Practitioner | 6565 S Yale Ave, Suite 508, Tulsa, OK 74136-8327 | 2016-09-02 |
| 1467906305 | Alisha Wilke | Nurse Practitioner | 11200 N Portland Ave, Oklahoma City, OK 73120-5045 | 2016-08-09 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.