Randall Monteal Evans Jr.
Home Health Aide in Ferguson, MO. Individual provider (NPI-1).
NPI number1679009468
StatusActive
Last updated in NPPESMay 11, 2017
Details
- NPI
- 1679009468
- Entity type
- Individual (NPI-1)
- Name
- Mr. Randall Monteal Evans Jr.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 11, 2017
- Last updated
- May 11, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 374U00000X | Home Health Aide | – | – | Yes |
| 372500000X | Chore Provider | – | – | |
| 372600000X | Adult Companion | – | – | |
| 374T00000X | Religious Nonmedical Nursing Personnel | – | – |
Practice location
226 Bruce AveFerguson, MO 63135-2704
Phone 314-372-5011
Mailing address
226 Bruce AveFerguson, MO 63135-2704
Phone 314-372-5011
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