Evans, Jacqueline M
Evans, Jacqueline M is an individual health care provider with primary practice located at 631 Professional Dr Ste 170 , Lawrenceville GA 30046-3392. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as her primary health care specialty. Evans, Jacqueline M can be contacted via phone (678) 312-2663.Contact Information
Primary practice address
631 Professional Dr Ste 170
Lawrenceville GA 30046-3392
Phone: (678) 312-2663
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | 10160 | Georgia |
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | PA9112791 | Florida |
Profile Details
| NPI number | 1235775438 |
|---|---|
| LBN Legal business name | Evans, Jacqueline M |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 22nd, 2019 |
| Last updated | Feb 8th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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