Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 0101226911 | VA |
N | 208600000X | Surgeon | 0101226911 | VA |
Y | 2086S0102X | Surgical Critical Care | 61189 | SC |
N | 2086S0102X | Surgical Critical Care | MD60027234 | WA |
N | 2086S0127X | Trauma Surgeon | MD60027234 | WA |
NPI | 1316155575 |
---|---|
Provider Name | Dr. Heather Leigh Evans |
First Address | Charlotte, NC 28275-1461 |
Second Address | Charleston, SC 29425 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2007 |
Last Update Date | 16/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0239217 | L&I (01) | WA |
1316155575 | (05) | WA |
MD60027234 | WA STATE MEDICAL LICENSE (01) | WA |