1881924843 NPI number — CHRISTINA A EVERTS ARNP

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881924843 NPI number — CHRISTINA A EVERTS ARNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
EVERTS
Provider First Name:
CHRISTINA
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
ARNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1881924843
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/11/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
DEPT CH 14389
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PALATINE
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60055-4389
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
785-295-8108
Provider Business Mailing Address Fax Number:
785-270-7646

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2835 SW MISSION WOODS DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TOPEKA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66614-5616
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-271-1818
Provider Business Practice Location Address Fax Number:
785-232-0739
Provider Enumeration Date:
01/13/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  53-75066-101 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 53-75066-101 . This is a "KS LICENSE #" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".




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