Provider Demographics
NPI:1871773457
Name:EVANS, KARYN A (RD, LDN)
Entity type:Individual
Prefix:
First Name:KARYN
Middle Name:A
Last Name:EVANS
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:KARYN
Other - Middle Name:V
Other - Last Name:ALVESTAD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RD, LDN
Mailing Address - Street 1:PO BOX 8428
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27835-8428
Mailing Address - Country:US
Mailing Address - Phone:252-847-2273
Mailing Address - Fax:252-847-2964
Practice Address - Street 1:2100 STANTONSBURG RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-2818
Practice Address - Country:US
Practice Address - Phone:252-847-2273
Practice Address - Fax:252-847-2964
Is Sole Proprietor?:No
Enumeration Date:2007-11-12
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL003103133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2995070Medicare PIN